Mastication and Late Mandibular Fracture After Surgery of Impacted Third Molars Associated With No Gross Pathology

Iatrogenic Mandibular Fracture Associated with Third Molar Removal

“…However, Al-Belasy et al 21 claimed that mastication does not affect late mandibular fracture after the surgical removal of impacted third molars associated with no gross pathology in patients more than 25 years of age who are fully dentate or missing one or two teeth, exhibit no mandibular atrophy, and have no systemic problems that may impair bone strength. In light of these findings, we did not apply rigid fixation in Case 1, but performed semi-rigid fixation using four orthodontic brackets and elastic rondelles on both sides.…”

Pathological mandibular fractures: a review of the literature of the last two decades

“…Several risk factors can be associated with this type of pathological fracture, such as age, gender, types of impaction, existing infection or bony lesions, surgical technique, and patient's compliance (in particular, chewing of hard foods after extraction) (1,14,21,26,27).…”

“…Age seems to be an important risk factor for pathological mandibular fractures following third molar removal. In the recent literature (Table 1), increased rates of fractures were observed in patients over 40 years of age (1,14,21,27). In particular, many studies report values of mean age ranging from 22 to 53 (1,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

“…Pathological fractures usually may be determined by surgical interventions (third molar removal and implant placement), result from regions of osteomyelitis, osteoradionecrosis (ORN), and bisphosphonate‐related osteonecrosis of the jaw (BRONJ), occur because of idiopathic reasons or be facilitated by cystic lesions, benign, malignant, or metastatic tumors .…”

Computer-aided technologies in diagnostics and therapy of impacted teeth

“…U ovakvim slučajevima kompjuterska analiza i procena jači-ne mandibule pre i/ili posle ekstrakcije impaktiranog zuba pomaže u donošenju kvalitetnih odluka u vezi planiranja ekstrakcije, toka postoperativnog lečenja i moguće neophodnosti za terapijskom profilaksom izbegavanja moguće frakture donje vilice. Kompjuterska procena jačine mandibule vrši se pomoću metode konačnih elemenata (finite element method) kojom se mogu odrediti različiti parametri pre-i postoperativnog toka i proceniti opšti uticaj sila u vidu Von Mises-ovog stresa mandibule 32,33 . Trodimenzionalni model mandibule kompjuterski se dobijaju iz KT snimaka, pa se na njega softverski nanose konačni elementi koji uključuju puno i parcijalno opterećenje prilikom žvakanja, ali i drugih mogućih stanja mandibule 34 .…”