Influence of third molars in mandibular fractures. Part 1: mandibular angle—a meta-analysis

Armond, Anna Catharina Vieira; Martins, Carolina Castro; Glória, José Cristiano Ramos; Galvão, Endi Lanza; Santos, Cássio Roberto Rocha dos; Falci, Saulo Gabriel Moreira

doi:10.1016/j.ijom.2017.02.1264

Cited by 27 publications

(44 citation statements)

References 29 publications

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“…8,23,24 Another interesting finding in different studies was the protective effect which the presence of third molars had on the condyle of the mandible and a similar effect which absence had on the angle of the mandible. 25,26 The angulation of the mandibular third molar is also known to have a profound effect on the site of mandibular fracture, complementary to our results. Our results were supported by studies of Revanth et al and Fuselier et al for the group A (angle fracture) patients, who also found mesioangular impactions more prevalent.…”

Section: Discussionsupporting

confidence: 87%

“…A theory that the presence of a mandibular third molar tends to reduce the cross-section area of the angle which in turn reduces the tensile strength of the bone, encouraging the propagation of fracture along the path of least resistance, was supported by Safdar and Meechan and Ma'aita and Alwrikat,1122 but was in conflict with Wolujewicz, Tevepaugh and Dodson, and Lee and Dodson who failed to establish this relation 82324. Another interesting finding in different studies was the protective effect which the presence of third molars had on the condyle of the mandible and a similar effect which absence had on the angle of the mandible 2526…”

Section: Discussionmentioning

confidence: 96%

“…Class II position B acts as protective factors for condyle fractures. 25,26 The developed roots of the mandibular third molar were also taken as a determinant for the angle and condyle fracture pattern. Similar results were found by a retrospective study performed by Mah et al who proved that condylar fractures were mostly associated with tooth germs or undeveloped roots, while horizontal impactions were a more common etiology for angle fractures due to the completely developed ones, hence concluding that mandibular angle and condyle fractures were significantly affected by the presence of third molar and continuity of cortical bone at the angle.…”

Section: Discussionmentioning

confidence: 99%

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Impacted Mandibular Third Molars and Their Influence on Mandibular Angle and Condyle Fractures

Mehra

Anehosur

Kumar

2019

Craniomaxillofacial Trauma & Reconstruction

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The aim of this study is to retrospectively analyze the effect unerupted or partially erupted third molars have on the angle and condyle fracture patterns of the mandible. It also focuses on evaluating the type of impaction that causes angle fracture and the level at which the condyle most commonly fractures. The study involves all the patients who had undergone treatment for condylar and angle of the mandible fractures from 2010 to 2017 in our craniofacial center. The case records and orthopantomograms of each patient were taken into consideration and a correlation was established based on gender, age, etiology, presence of third molars, position of third molars, angulation, and root development of third molars. Of the 150 angle fracture patients, 146 had third molars and 4 did not, whereas of the 130 condyle fractures, third molar was present in 54 patients and absent in 76. The prevalence of angle fractures was statistically significant when a third molar was present, whereas the prevalence of condyle fractures was higher when third molar was absent. The results of age, etiology, angulation, position, and root development of third molars were also statistically significant. However, sex of the patient did not influence the fracture pattern. The presence of an impacted third molar or a completely erupted one has a definite influence on the fracture pattern of the mandible. The occurrence of angle and condyle fractures was mostly affected by the continuity of the cortical bone at the angle of the mandible. Hence, prophylactic removal of mandibular third molars does increase the risk of condyle fractures.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Impacted Mandibular Third Molars and Their Influence on Mandibular Angle and Condyle Fractures

Mehra

Anehosur

Kumar

2019

Craniomaxillofacial Trauma & Reconstruction

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“…The number of patients who require orthodontic treatment is far beyond this number. Among CMF conditions, the mandible is one of the most frequently deformed or injured regions, with 76% of facial trauma affecting the mandibular region [2].…”

Section: Introductionmentioning

confidence: 99%

Deep Geodesic Learning for Segmentation and Anatomical Landmarking

Torosdagli

Liberton

Verma

et al. 2019

IEEE Trans. Med. Imaging

112

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In this paper, we propose a novel deep learning framework for anatomy segmentation and automatic landmarking. Specifically, we focus on the challenging problem of mandible segmentation from cone-beam computed tomography (CBCT) scans and identification of 9 anatomical landmarks of the mandible on the geodesic space. The overall approach employs three inter-related steps. In step 1, we propose a deep neural network architecture with carefully designed regularization, and network hyper-parameters to perform image segmentation without the need for data augmentation and complex postprocessing refinement. In step 2, we formulate the landmark localization problem directly on the geodesic space for sparselyspaced anatomical landmarks. In step 3, we propose to use a long short-term memory (LSTM) network to identify closelyspaced landmarks, which is rather difficult to obtain using other standard detection networks. The proposed fully automated method showed superior efficacy compared to the state-of-theart mandible segmentation and landmarking approaches in craniofacial anomalies and diseased states. We used a very challenging CBCT dataset of 50 patients with a high-degree of craniomaxillofacial (CMF) variability that is realistic in clinical practice. Complementary to the quantitative analysis, the qualitative visual inspection was conducted for distinct CBCT scans from 250 patients with high anatomical variability. We have also shown feasibility of the proposed work in an independent dataset from MICCAI Head-Neck Challenge (2015) achieving the state-of-the-art performance. Lastly, we present an in-depth analysis of the proposed deep networks with respect to the choice of hyper-parameters such as pooling and activation functions.

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“…The mandible is considered the strongest bone in the facial skeleton. However, because of its exposed position and anatomic configuration, traumatic force leading to mandibular fractures are reported to be high, comprising of 76% of all maxillofacial fractures [1][2][3]. Mandibular fracture patterns depend on multiple factors: the direction and extent of force applied, presence and amount of soft tissue protection, and biomechanical characteristics of the mandible bone itself (such as bone density) [2].…”

Section: Introductionmentioning

confidence: 99%

Relationship between mandible fractures and third molars

Lee

Kim

Lee

et al. 2019

Arch Craniofac Surg

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Background: This study was conducted to determine the relationship between third molar (M3) and mandibular fracture. Methods: Patients with unilateral mandibular angle or condyle fractures between 2008 and 2018 were evaluated retrospectively. Medical records were reviewed regarding the location of fractures, and panoramic radiographs were reviewed to discern the presence and position of ipsilateral mandibular third molars (M3). We measured the bony area of the mandibular angle (area A) and the bony area occupied by the M3 (area B) to calculate the true mandibular angle bony area ratio (area A-B/area A × 100). Results: The study consisted of 129 patients, of which 60 (46.5%) had angle fractures and 69 (53.5%) had condyle fractures. The risk of angle fracture was higher in the presence of M3 (odds ratio [OR], 2.2; p < 0.05) and the risk of condyle fracture was lower in the presence of M3 (OR, 0.45; p < 0.05), than in the absence of M3. The risk of angle fracture was higher in the presence of an impacted M3 (OR, 0.3; p < 0.001) and the risk of condyle fracture was lower in the presence of an impacted M3 (OR, 3.32; p < 0.001), than in the presence of a fully erupted M3. True mandibular angle bony area ratio was significantly lower in the angle fractures than in the condyle fractures (p = 0.003). Conclusion: Angle fractures had significantly lower true mandibular angle bony area ratios than condyle fractures. True mandibular angle bony area ratio, a simple and inexpensive method, could be an option to predict the mandibular fracture patterns.

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Influence of third molars in mandibular fractures. Part 1: mandibular angle—a meta-analysis

Cited by 27 publications

References 29 publications

Impacted Mandibular Third Molars and Their Influence on Mandibular Angle and Condyle Fractures

Impacted Mandibular Third Molars and Their Influence on Mandibular Angle and Condyle Fractures

Deep Geodesic Learning for Segmentation and Anatomical Landmarking

Relationship between mandible fractures and third molars

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