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Presented ByDr. Rahul TiwariFinal Yr. MDSOMFS, SIDS

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TITLE

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Relationship between fracture of mandibular condyle and absence of unerupted

mandibular third molar—a retrospective study

Ritesh Rajan, Dinesh Kumar Verma, R. M. Borle & Abhilasha Yadav

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TERMINOLOGY

1. CONVENTIONAL RADIOGARPHY

1. OPG

2. REVERSE TOWNE’S

3. TRANSCRANIAL VIEWS FOR TMJ

2. CT SCAN

3. MRI

4. ARTHROGRAPHY

Any third molar partially or completely covered by bone was regarded as unerupted.

INVESTIGATIONS

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REVIEW OF LITERATURE

Total – 319

Deciduous and Mixed - 29Dentulous- 113Quadrants Missing- 46Edentulous - 30Individual Missing Teeth- 101

Frequency of edentulous mandibular fractures was found to be 7.3% more. 20% more reported by Halazonetis 9% more recorded by Huelke et al.

34 Patients

1961

1988

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REVIEW OF LITERATURE

40% less chance of # of mandible in fully erupted 3rd molars

Pt. with 3M present have higher risk of mandibular angle fracture however depends on position

437 patients

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REVIEW OF LITERATURE

Unerupted third molar teeth weaken the mandibular angle both quantitatively and qualitatively.

200 X rays

Patients with fractured mandibles and mandibular third molars are 3.8 times more likely to have an angle fracture

73 Patients

1995

1995

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REVIEW OF LITERATURE

Dental screening and early removal of impacted teeth can reduce the risk of mandibular fractures in young adults participating in contact sports.

Factures at the condylar region showed a significantly higher incidence in patients without unerupted third molars. Removal of unerupted mandibular third molars predisposes the mandible to condyle fractures.

439 Patients

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Abstract:Keywords:

• Condylar fracture .Angle fracture .Impacted third molar . Unerupted third molar

PURPOSE:

• The purpose of the present study was to find, if there exists, a co-relation

between presence of unerupted mandibular third molar and fracture of

mandibular condyle.

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METHODS

• A retrospective, multicenter study was done collecting the data of all mandibular

condyle fractures treated from November 2006 till August 2015.

• Data was collected from the patient’s records and radiographs for the following

information: age, sex, etiology of fracture, presence and state of lower third molars,

and associated fracture.

• The results were subjected to statistical analysis

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CRITERIA

• A fracture line extending from the sigmoid notch and involving condylar process

was categorized as a condylar fracture.

• Patients were divided into two groups based on the presence or absence of

unerupted mandibular third molar. Any third molar partially or completely

covered by bone was regarded as unerupted.

• The data was analyzed by calculating the means and standard deviation, and

cohort comparisons were made by the chi square test and the Student’s T test. P

value of <0.05 was considered significant.

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PATIENT CHARACTERSTICS

180- 35/145

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RESULTS

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RESULTS

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RESULTS

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RESULTS

Frequency of multiple fractures for patient with and without the unerupted third molars

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TREATEMENT REASONS

• Treatment of condyle fracture is more fraught with the difficulty in repositioning the

condylar fragments, placement of fixation hardware, and danger of injuring facial

nerve.

Angle fractures are more amenable to excellent reduction and stable fixation

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conclusion

• This study suggests that the fractures of mandibular condylar region have a

significantly higher incidence in patients without an unerupted mandibular third

molar.

• But further studies with larger sample size and comparison with angle of

mandible fracture incidence are necessary before drawing any definitive

conclusion.

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OTH

ER R

EFER

ENC

ES

1102 mandibular fractures in 600 patients. Patients with impacted M3s were three times more likely to develop angle fractures and less likely to develop condylar fractures than those without impacted M3s.

398 patients, older than 18 years, with 464 mandibular fractures. Unerupted mandibular third molars significantly reduced the occurrence of condylar fractures.

110 fractures of the mandibular condyle and 80 of the angle. An incompletely erupted third molar reduces the risk of condylar fractures and increases the risk of fractures of the mandibular angle.

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OTH

ER R

EFER

ENC

ES

2015

2014

2014

147 mandibular fracture. Condylar fracture was two times greater in those with missing or completely erupted mandibular third molars as compared to those with unerupted ones.

118 mandibular angle and condyle fractures in 110 patients. presence of impacted third molar predisposesthe angle to fracture and reduces the risk of a concomitant condylar fracture

100 Patients. Practice of prophylactic removal of mandibular third molar and resultant strengthening of angle region should be reconsidered, as it increases the risk of fracture at condylar region which is difficult to treat and associated with more morbidity.

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OTH

ER R

EFER

ENC

ES

2014

CT Scan on mandible models were made.

A force of 2000 N was applied to three different regions of the models: the symphysis, ipsilateral body, and contralateral body.

When the force was applied to the mandibular body, the results revealed increased angle fragility in cases with unerupted M3.

When the force was applied to the symphysis, the condyle region showed higher fragility, irrespective of the presence of an unerupted M3.

In summary, fragility of the angle and condyle regions depends on the presence of an unerupted M3 and on the direction and point of impact of the force.

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