Effect of Lower Third Molar -Presence and Position on the Occurrence Mandibular Angle and Condyle Fractures: A Prospective Clinical Study

Objectives:This study was conducted to evaluate the effect of the presence and angulation of mandibular third molars on the occurrence of mandibular angle and condylar fractures. Materials And Methods: A clinical study was carried out on patients with mandibular angle and /or condylar fractures attended the governmental hospitals in Erbil City from June 2015 to June 2016. Data sources were patients' hospital charts and panoramic radiographs. Predictor variables were the presence and orientation of mandibular third molars according to Pell and Gregory and Winter Classifications. Outcome variables were the presence of angle and condylar fractures. Other study variables included age, gender, and fracture aetiology. Data were analyzed using the χ2 test and Student t test. Results: The study sample consisted of 29 patients (22 males and 7 females) with 32 fractures sites with an average age of 26.5 years (range17-50 years). The results revealed that the risk of mandibular angle fracture was significantly higher in patients with impacted mandibular third molars (P < .001) and the risk of mandibular condylar fracture was significantly higher in patients lacking mandibular third molars (P < .001). The highest risk for mandibular angle fracture was associated with mesioangular angulation (58.8%) followed by vertical (35.3%) ones. Impacted mandibular third molars with Pell and Gregory class IIB orientation were most associated with mandibular angle fractures. Conclusion: The presences of impacted mandibular third molars increase the risk of mandibular angle fracture and simultaneously decreased the risk of mandibular condylar fracture.