Evaluation of the Prognosis of the Teeth in the Mandibular Fracture Line

Abstract

Objective: The aim of this study was to evaluate the prognosis of the teeth in the mandibular fracture line and to analyze the relationship between the degree of displacement of fracture fragments, the relationship of the fracture line to the periodontium, and the relationship between the condition of the teeth at the first postoperative (post-op) year. Methods: A total of 60 teeth from 38 patients (11 female and 27 male) who had erupted teeth in the line of mandibular fracture and were treated with open reduction were examined. The data were collected from the patients’ clinical records and radiographs. Age at the time of injury, gender, cause of trauma, site of fracture, the relationship of the fracture line to the periodontium, the degree of displacement of fracture fragments, and the condition of the teeth in the line of the fracture at the first post-op year were evaluated. Results: The degree of displacement of fracture fragments had an effect on the condition of the teeth at the first post-op year ( P = .036) and the regions of the mandible had an effect on the degree of displacement of the fracture fragments ( P = .000). The survival rate of the pulp of the teeth was 69.8%. Conclusions: A preventive approach should be preferred for teeth in the mandibular fracture line. Retained teeth in the fracture line should be monitored clinically and radiologically for at least 1 year, and unnecessary endodontic treatments should be avoided.

Characteristics and management of teeth in the line of mandibular fractures treated with internal fixation

“…Therefore, type II fractures had a better prognosis for the pulps 5 . A study on the prognosis of teeth in the fracture line showed better pulp outcomes for types II and III involvement 25 . Other studies showed a predominance of type I, followed by type II 11,14 .…”

“…Other studies showed a predominance of type I, followed by type II 11,14 . However, it has been described that the type of fracture according to the relationship between the fracture line and the periodontium did not influence the occurrence of complications, with greater importance of the location of the fracture 11,25 …”

Mandibular Fractures: Diagnosis and Management

“…[59][60][61] A systematic review by Fernandes et al similarly failed to show any statistically significant difference in complication rates. 62 When teeth in the line of the fracture impair adequate reduction of the bony segments, are involved in an infected fracture, are mobile due to fracture or periodontal disease, have associated drainage, periapical radiolucency, or are themselves fractured, they should be removed. [61][62][63][64] For teeth otherwise involved in the lines of fractures, recent recommendations advise clinical and radiographic monitoring for at least 1 year and avoid unnecessary, costly endodontic procedures.…”

“…62 When teeth in the line of the fracture impair adequate reduction of the bony segments, are involved in an infected fracture, are mobile due to fracture or periodontal disease, have associated drainage, periapical radiolucency, or are themselves fractured, they should be removed. [61][62][63][64] For teeth otherwise involved in the lines of fractures, recent recommendations advise clinical and radiographic monitoring for at least 1 year and avoid unnecessary, costly endodontic procedures. 63 When a symptomatic tooth needs to be removed, it should ideally be removed once an adequate healing period has occurred, typically at a minimum of 3 months following reduction.…”

“…[61][62][63][64] For teeth otherwise involved in the lines of fractures, recent recommendations advise clinical and radiographic monitoring for at least 1 year and avoid unnecessary, costly endodontic procedures. 63 When a symptomatic tooth needs to be removed, it should ideally be removed once an adequate healing period has occurred, typically at a minimum of 3 months following reduction.…”