Prevalence of intraoperative and postoperative iatrogenic mandibular fractures after lower third molar extraction: A systematic review.

ABSTRACT

BACKGROUND: The surgical extraction of the lower third molars is one of the most common procedures in oral surgery, and this surgical operation can cause intra- and postoperative complications such as pain, trismus, bleeding, infection, oedema, inferior alveolar nerve injuries, displacement of teeth to neighbouring spaces and mandibular fractures. The aim of this systematic review is to report the prevalence of mandibular fractures that occur intra- and postoperatively in patients who have undergone surgical removal of the lower third molar. MATERIAL AND METHODS: An electronic database search for articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted using the key words "Molar, Third"; "Mandibular Fractures"; "Molar Third, Removal"; "Molar Third, Complications"; "Dental Extractions, Complications"; "Mandibular Fractures, Third molar removal". The inclusion criteria were articles including at least 10 patients and were published in English in the last 10 years. The exclusion criteria were nonhuman studies and case reports. RESULTS: Postoperative mandibular fractures after 3MI occur more frequently in male patients between the ages of 40 and 60 and are caused by premature chewing force. The parameters that most frequently characterise mandibular fractures at the mandibular angle are deeply impacted lower third molars, Class II and III, B and C, according to the Pell & Gregory classification system, mesioangular according to the Winter's classification, and are located on the left mandibular side.. CONCLUSIONS: Mandibular fractures can be predicted with adequate preoperative planning for each case and identify the related risk factors for this complication. Key wordsMolar, Third; Mandibular Fractures; Molar Third, Removal; Molar Third, Complications; Dental Extractions, Complications; Mandibular Fractures, Third molar removal.