Oral Maxillofac Surg DOI 10.1007/s10006-016-0548-3

ORIGINAL ARTICLE

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar—a retrospective study Ritesh Rajan 1 & Dinesh Kumar Verma 2 & R. M. Borle 3 & Abhilasha Yadav 4

Received: 30 September 2015 / Accepted: 5 February 2016 # Springer-Verlag Berlin Heidelberg 2016

Abstract Purpose The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle. Methods A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient’s records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis. Results Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p < 0.05). In the unerupted third molar present group, isolated bilateral condylar fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar

* Dinesh Kumar Verma [email protected]

1

Department of Oral and Maxillofacial Surgery, SVS Institute of Dental Sciences, Mehbubnagar, Telenganam 500008, India

2

Department of Oral & Maxillofacial Surgery, Surendera Dental College & Research Institute, Sri Ganganagar, Rajasthan 335001, India

3

Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Sawangi, Distt.-Wardha, Maharashtra 442001, India

4

Sharad Pawar Dental College and Hospital, Sawangi, Distt.-Wardha, Maharashtra 442001, India

fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032). Conclusion This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar. Keywords Condylar fracture . Angle fracture . Impacted third molar . Unerupted third molar

Introduction The mandible is the most common of the facial bones to fracture [1]. Mandibular fracture patterns depend on multiple factors, including direction and amount of force, presence of soft tissue bulk, and biomechanical characteristics of the mandible such as bone density and mass or anatomic structures creating weak areas [2–5]. Hulke et al. [6–8] reported a significant relationship between fracture location and the presence of a tooth-bearing area. The study by Reitzik et al. on isolated cervet monkey cadaver mandible showed that mandibles with unerupted mandibular third molar required 40 % less force to be fractured than mandibles with fully erupted third molars [9]. Several other authors have reported that patients with unerupted mandibular third molars were more likely to have an angle fracture than those patients without unerupted

Oral Maxillofac Surg Table 1 Patient characteristics Characteristics

Sex

Unerupted third molar present

Unerupted third molar absent

P value

29 6

126 19