Department of Dentistry, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.
Acta Medica (Hradec Kralove). 2021;64(2):101-107. doi: 10.14712/18059694.2021.18.
Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.
医源性下颌骨骨折是拔牙的罕见并发症,发病率为 0.0033-0.0034%。本研究回顾性分析了 2006 年 4 月至 2019 年 3 月期间 8 例因拔牙导致下颌骨骨折的患者。评估的参数包括患者的年龄和性别、拔牙方法、骨折的侧别分布、所拔牙齿的类型、下颌第三磨牙的位置、与牙齿相关的骨病理性病变的存在、骨碎片的移位以及颏神经支配区的感觉障碍。根据 Pell 和 Gregory 分类法和 Winter 分类法评估下颌第三磨牙的位置和阻生情况。1 例为左侧骨折,7 例为右侧骨折。6 例采用 Winter 拔牙挺。7 例患者采用钢板螺钉稳定固定进行手术治疗。1 例患者采用保守治疗。本研究分析了医源性下颌骨骨折的原因,并提出了降低其发生风险的建议。