Association between third molar and mandibular angle fracture: A systematic review and meta-analysis

Publication date: Available online 17 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Francesco Giovacchini, Daniele Paradiso, Caterina Bensi, Stefano Belli, Giuseppe Lomurno, Antonio Tullio
PurposeThe aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the mandibular fracture occurs.MethodsA systematic literary search was performed in Pubmed, Scopus, and the Cochrane Library for observational studies with at least 250 patients that included frequency of mandibular angle fracture, presence of third molar, and its position.ResultsA total of seven studies were included in the review, from an initial search of 622 titles. The relative risk of mandibular angle fracture with third molar was 1.90 (95% CI = 1.47–2.46). The relative risk of mandibular angle fracture related to third molar position (according to the Pell and Gregory classification) was 1.18 (95% CI = 0.62–2.25), 1.98 (95% CI = 0.95–4.10), 2.72 (95% CI = 1.78–4.16), 1.31 (95% CI = 0.80–2.14), 2.21 (95% CI = 1.69–2.87) and 2.99 (95% CI = 2.12–4.22) for Class A, Class B, Class C, Class I, Class II, and Class III, respectively.ConclusionsOur meta-analysis reported a two-fold increased risk of mandibular angle fracture with the presence of a third molar in patients who presented with mandibular fractures. Even the third molar position seemed to influence mandibular angle fracture, especially Class C, Class II, and Class III.



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