Mandibular fracture after third molar removal: a case report.

Surgical removal of third molars is associated with complications that can be as common as pain and trismus and as rare as mandibular fracture. A fracture can occur when the resistance of the bone tissue is lower than the forces applied by the surgeon during the procedure. The aim of this article is to report a case of jaw fracture after tooth extraction and subsequent surgical treatment of the fracture under general anesthesia with an option for a submandibular approach. A plate and screw system with a 2.4-mm profile was used for osteosynthesis after reduction of the fracture. The patient was followed up for 6 months after surgery and reported no functional or esthetic complaints. Treatment of mandibular fractures should aim to reestablish functional occlusion and mandibular continuity with the least possible risk of adverse sequelae. Planning for each individual case of third molar extraction requires accurate clinical examination and image evaluation to lessen the risk of fracture.

Surgical Treatment of Osteoma in the Basilar Region of the Mandible.

Osteoma is an uncommon benign osteogenic tumor characterized by the proliferation of compact and cancellous bone. The objective of this study was to report a case of osteoma in the basilar region of the mandible. The patient reported no pain, but the affected area was tender to touch and there was esthetic concern because of the apparent swelling. The mass measured approximately 5 cm in diameter and extended to the lingual area of the mandible. A vestibular approach was used for surgical treatment. After infiltration of a local anesthetic and vasoconstrictor, to expose the mandibular ramus, an incision was made with an electric scalpel along the external oblique ridge through the mucosa, submucosa and muscle, fascia and periosteum until the lower second molar, 3 to 5 mm inferior to the mucogingival junction. A mucoperiosteal flap was raised until the base of the mandible to access the tumor. Osteotomy was performed and the tumor was removed. The patient shows no recurrence of the tumor after 1 year and 6 months of follow-up. Periodical clinical and radiographic follow-up are satisfactory since recurrence is rare.

Suitability of Wrist External Fixator for Treatment of Mandibular Fracture.

The mandibular fracture is one of the most commonly fractures of the facial bones. In high-energy traumas, a comminuted mandible fracture may occur. The closed reduction with external fixator is an interesting alternative for these types of fractures. The aim of this article is to report the case of a patient with comminuted fracture in the right mandibular body, whose surgical treatment was the noninvasive reduction of fracture and stabilization using a Colles' wrist external fixator. After 1 year of follow-up, the patient is without complaints, with satisfactory dental occlusion, adequate contour, and mandibular alignment. External fixation with wrist orthopedic fixators adapted to the mandible provides many advantages owing to its versatility and simplicity of use. Therefore, this method should be remembered as a valid and affordable option for the treatment of complex lesions when indicated correctly.

Incidence and classification of bifid mandibular canals using cone beam computed tomography

Aim: To determine the prevalence and classification of bifid mandibular canals using cone beamcomputed tomography (CBCT). Methods: The sample comprised 300 CBCT scans obtainedfrom the Radiology and Imaging Department database at São Leopoldo Mandic Dental School,Campinas, SP, Brazil. All images were performed on Classic I-Cat® CBCT scanner, withstandardized voxel at 0.25 mm and 13 cm FOV (field of view). From an axial slice (0.25 mm) aguiding plane was drawn along the alveolar ridge in order to obtain a cross-section. Results:Among 300 patients, 188 (62.7%) were female and 112 (37.3%) were male, aged between 13to 87 years. Changes in the mandibular canal were observed in 90 patients, 30.0% of thesample, 51 women (56.7%) and 39 men (43.3%). Regarding affected sides, 32.2% were on theright and 24.5% on the left, with 43.3% bilateral cases. Conclusions: According to the resultsobtained in this study, a prevalence of 30% of bifid mandibular canals was found, with the mostprevalent types classified as B (mesial direction) and bilateral.