Dos Santos Silva Weuler, Silveira Rubens Jorge, de Araujo Andrade Michelle Gouveia Benicio, Franco Ademir, Silva Rhonan Ferreira
Department of Maxillofacial Surgery, Public Hospital of Urgency, AnapolisBrazil.
Department of Maxillofacial Surgery, Paulista University, GoianiaBrazil.
J Oral Maxillofac Res. 2017 Jun 30;8(2):e5. doi: 10.5037/jomr.2017.8205. eCollection 2017 Apr-Jun.
The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication.
A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established. A second surgery, under general anaesthesia, was performed for the fixation of the mandibular bone.
The fractured parts were reduced and fixed with locking plate systems and 2 mm screws following load-sharing principles. The masticatory function showed optimal performance within 7 and 21 days after the surgery. Complete bone healing was observed within 1 year of follow-up.
For satisfactory surgical outcomes, adequate surgical planning and techniques must be performed. Signed informed consents explaining the risks and benefits of the treatment must be used to avoid ethical and legal disputes in dentistry.
本研究报告一例因下颌第三磨牙拔除导致的晚期下颌骨骨折病例，并强调与该手术并发症相关的临床、伦理和法律问题。
一名女性患者接受了下颌右侧第三磨牙的拔除手术。术后两天，患者报告下颌右侧疼痛和咬合改变。经过临床和影像学复查，确诊为晚期下颌骨骨折。在全身麻醉下进行了第二次手术，以固定下颌骨。
按照负载分担原则，使用锁定钢板系统和2毫米螺钉对骨折部位进行复位和固定。咀嚼功能在术后7至21天内表现最佳。随访1年内观察到骨完全愈合。
为获得满意的手术效果，必须进行充分的手术规划并采用适当的技术。必须使用签署的知情同意书解释治疗的风险和益处，以避免牙科领域的伦理和法律纠纷。
