Case report
Late Mandibular Fracture After Lower Third Molar Extraction in a Patient With Stafne Bone Cavity: A Case Report

https://doi.org/10.1016/j.joms.2009.06.019Get rights and content

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Report of a Case

A 54-year-old Japanese man presented to our clinic with a change of occlusion and swelling at the left mandibular angle area. We reviewed the patient's history of dental treatment and found that he had had swelling over the left lower third molar area for approximately 1 week and had visited a local dental clinic on October 18, 2007. The dentist took a periapical film, and a left mesio-angulately impacted third molar with pericoronitis was suspected but cast no radiolucent shadow on the film.

Discussion

Late mandibular fracture is not a common complication of removal of a lower third molar. According to 3 extensive data mining evaluations, the incidence is approximately 0.0046% to 0.0075%.2, 4 The condition usually occurs in the patients more than 40 years old with full dentition, and at 2 to 3 weeks postextraction, the left side is affected more frequently than the right, and the incidence is greater in male than in female patients.3 The associated factors of this complication include age,

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Cited by (21)

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    A recent literature review reported 74% of fractures occurred postoperatively, and 26% of pathologic mandibular fractures were observed intraoperatively.46 A soft diet is recommended for 4 weeks postoperatively, especially in patients with full dentition who have risk factors for mandibular fracture.34,52–54 In the severely atrophic mandible, the clinician should avoid wide diameter implants and penetration through the inferior border of the mandible, which can significantly weaken the jaw.45

  • Extraction of impacted third molar with preventive installation of titanium miniplate: Case report

    2020, Annals of Medicine and Surgery
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    In our case, extraction was indicated in a female patient, however she was 45 years old and the third molar was impacted in class III, type C (according to Pell and Gregory classification), representing a surgical procedure that deserves attention. Additional causes, other than the chewing phenomenon may lead to late mandibular fractures, such as systemic disorders that causes bone's fragility (osteoporosis, hyperparathyroidism, rheumatism, osteogenesis imperfecta and Pajet disease) and local trauma with impact on the surgical site [1,2,7,9]. During the extraction, it is worth mentioning that it is always preferable to perform as many tooth sections as necessary, minimizing ostectomy and, consequently, reducing the fragility of the mandible and the incidence of fracture [3,10,11].

  • Late mandibular fracture occurring in the postoperative period after third molar removal: systematic review and analysis of 124 cases

    2017, International Journal of Oral and Maxillofacial Surgery
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    Fifty-three full-text articles were assessed for eligibility (Fig. 1). Finally, 36 articles were selected; these articles included 124 clinical cases associated with mandibular fracture after the removal of a lower third molar (Table 1).2–8,15–43 The patient's sex was documented for 80 of the 124 cases and the exact age for 102 of them.

  • Surgical removal of a third molar at risk for mandibular pathologic fracture: Case report and clinical considerations

    2012, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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    Moreover, in such cases, the preservation of inferior alveolar nerve integrity also may be challenging.3,4,8,9 Several factors contribute to weakening of the mandible and may be associated with mandibular fracture after third molar removal: adult age, male sex, deep impaction, ankylosis of the tooth, existing cystic lesion, and patient's lack of compliance (such as chewing of hard foods after extraction).1,2,5,7,10,11 Intraoperative mandibular fractures might occur because of improper instrumentation and application of excessive force to the bone during tooth removal, but postoperative fracture cannot be explained with unappropriate surgical force.2,5

  • Pathological Mandible Fracture Resulting from Osteomyelitis after Third Molar Removal: A Case Study

    2024, Open Dentistry Journal

  • Current Frequency of Mandibular Condylar Process Fractures

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