Prognosis of teeth in mandibular fracture lines

Abstract

Background/Aims Teeth in a jaw fracture line, because of the presence of the periodontal ligament, may communicate with the oral cavity. There are no guidelines for the management of teeth in mandibular fracture lines. The aim of this study was to investigate the factors related to dental problems with teeth involved in mandibular fracture lines and to determine the best treatment option. Material and Methods This retrospective study was based on the medical and radiographic records of patients with mandibular fractures. The relationships among the patient’s age, gender, smoking history, amount of bony displacement, surgery, trauma‐surgery period, apical involvement, tooth mobility, and periodontal status were investigated. Group comparisons were performed using the chi‐squared test, Fisher’s exact test, and Mann–Whitney U‐test. Result A total of 238 patients (247 fracture lines) with mandibular fractures including a tooth in the line of the fracture were examined. Post‐operative dental complications occurred in 42 cases (17.0%). Extraction of related teeth occurred in 34 cases (80.9%) compared to eight cases (19.0%) related to root canal therapy. This study defined “dental problem” as “a case with a tooth extracted or endodontically treated after trauma.” The variables associated with an increased risk of dental problems were the amount of bony displacement (p < .01), tooth mobility (p < .01), and pre‐existing marginal alveolar bone loss (p = .027). Conclusion The prognosis of teeth in mandibular fracture lines was related to tooth mobility, periodontal state, and the amount of bony displacement.

The Evaluation of Objective and Subjective Fate of Teeth in the Mandible Fracture Line and the Management—A Center’s Experience

“…Even with preservation, various other progressions of complications were reviewed and might happen during the follow-up. 19 Interestingly, in a research report offered by Neal et al, 20 the rate of complications came to 16.1% in patients who underwent initial extractions without trying to preservative, whereas the complication rate of the teeth preserved was 13.7%, which showed no much difference in preservation of affected tooth if the decision were seriously concerned. Even though there seems to be a different result compared with us, we still got a significantly lower (5.12%) complication rate compared with the previous reports.…”

“…Similar to our results, in the retrospective study reported by Lee and colleagues, if the prophylactic extractions of teeth were carried out to those in the fracture lines, the evaluation of the follow-up revealed a lower incidence of complications compared with those who were left in place. Even with preservation, various other progressions of complications were reviewed and might happen during the follow-up 19 . Interestingly, in a research report offered by Neal et al, 20 the rate of complications came to 16.1% in patients who underwent initial extractions without trying to preservative, whereas the complication rate of the teeth preserved was 13.7%, which showed no much difference in preservation of affected tooth if the decision were seriously concerned.…”

Retention of teeth in the fracture gaps of the mandible: a retrospective analysis

“…Significant differences in the occurrence of dental problems were observed in teeth with a bony displacement exceeding 3 mm. The location of the fracture line in relation to the tooth apex seems not to affect the occurrence of dental problems [ 21 ].…”