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Iatrogenic Fracture of the Lower Jaw: A Rare Complication of Lower Molar Extraction

Radovan Mottl, Martina Kunderová, Radovan Slezák, Jan Schmidt

Abstract: 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.
Keywords: tooth extraction / classification / Winter / mandible fracture / lower third molar

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