Mehra Anhad, Anehosur Venkatesh, Kumar Niranjan
Department of Oral and Maxillofacial Surgery, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.
SDM Craniofacial Unit and Research Centre, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
Craniomaxillofac Trauma Reconstr. 2019 Dec;12(4):291-300. doi: 10.1055/s-0039-1685459. Epub 2019 Apr 2.
The aim of this study is to retrospectively analyze the effect unerupted or partially erupted third molars have on the angle and condyle fracture patterns of the mandible. It also focuses on evaluating the type of impaction that causes angle fracture and the level at which the condyle most commonly fractures. The study involves all the patients who had undergone treatment for condylar and angle of the mandible fractures from 2010 to 2017 in our craniofacial center. The case records and orthopantomograms of each patient were taken into consideration and a correlation was established based on gender, age, etiology, presence of third molars, position of third molars, angulation, and root development of third molars. Of the 150 angle fracture patients, 146 had third molars and 4 did not, whereas of the 130 condyle fractures, third molar was present in 54 patients and absent in 76. The prevalence of angle fractures was statistically significant when a third molar was present, whereas the prevalence of condyle fractures was higher when third molar was absent. The results of age, etiology, angulation, position, and root development of third molars were also statistically significant. However, sex of the patient did not influence the fracture pattern. The presence of an impacted third molar or a completely erupted one has a definite influence on the fracture pattern of the mandible. The occurrence of angle and condyle fractures was mostly affected by the continuity of the cortical bone at the angle of the mandible. Hence, prophylactic removal of mandibular third molars does increase the risk of condyle fractures.
本研究的目的是回顾性分析未萌出或部分萌出的第三磨牙对下颌骨角度和髁突骨折类型的影响。它还着重评估导致下颌角骨折的阻生类型以及髁突最常发生骨折的水平。该研究纳入了2010年至2017年在我们颅面中心接受下颌骨髁突和下颌角骨折治疗的所有患者。考虑了每位患者的病例记录和全景X线片，并基于性别、年龄、病因、第三磨牙的存在情况、第三磨牙的位置、倾斜度以及第三磨牙的牙根发育情况建立了相关性。在150名下颌角骨折患者中，146人有第三磨牙，4人没有；而在130例髁突骨折患者中，54人有第三磨牙，76人没有。存在第三磨牙时，下颌角骨折的患病率具有统计学意义，而不存在第三磨牙时，髁突骨折的患病率更高。第三磨牙的年龄、病因、倾斜度、位置和牙根发育结果也具有统计学意义。然而，患者的性别不影响骨折类型。阻生第三磨牙或完全萌出的第三磨牙的存在对下颌骨骨折类型有明确影响。下颌角和髁突骨折的发生主要受下颌角皮质骨连续性的影响。因此，预防性拔除下颌第三磨牙确实会增加髁突骨折的风险。
