Role of mandibular third molar in mandibular condylar fracture

Mandibular condylar fracture is one of the most common fractures of mandible. Presence or absence of mandibular third molar is an important risk factor in addition to various other factors. Presence of unerupted mandibular third molar concentrates the stress in angle region leading to its fracture while, in absence of unerupted third molar, forces are diverted towards condyle making it more vulnerable to injury. The objective of this study was to evaluate role of unerupted mandibular third molar in reducing incidence of condylar fracture. A cross sectional descriptive study was conducted at the department of Oral and Maxillofacial surgery, Ayub Medical College, Abbottabad, on 150 patients having condylar fractures over a period of eighteen months. Data on patient's demographics, side of condylar fracture and status of mandibular third molar was obtained and observed. Total number of hemimandibles under study was 175. In 120 patients i.e. 68.6% mandibular third molar was erupted while, in 55 patients i.e. 31.4%, mandibular third molar was unerupted. The results concluded that presence of unerupted mandibular third molar reduces incidence of condylar fracture by 2.2 times so prophylactic removal of these teeth in practice should be discouraged

Etiology, clinical and radiographic features of temporomandibular joint ankylosis

Objective of the study was to find out the frequency of different etiological factors, clinical and radiographic features of Temporomandibular joint ankylosis. Ninety six patients suffering from Temporomandibular joint ankylosis visited Oral and Maxillofacial Surgery Department, Khyber College of Dentistry, Peshawar from December 9, 2009 to December 8, 2010 and were included in the study. Patient demographics, etiology and clinical features of the disease were noted. Orthopantomograph was taken of all patients to confirm the diagnosis and to record the radiographic findings of the disease. Males were the predominant group [60.4%] as compared to females [39.6%]. Trauma was the etiological factor in 88.5% cases followed by infection and inflammation. Clinical deformity was present in the form of facial asymmetry [85.4%], < 5mm inter-incisal distance [76%], disturbed occlusion [64.6%] and poor oral hygiene [78.1%]. Bilateral involvement was found in 40.6% cases, left side was involved in 30.2% cases while right side was effected in 29.2% cases. Radio-graphically, the disease presented in the form of mushrooming of condyle, loss of joint space, anti-gonial notch and coronoid hyperplasia. Trauma is the main etiological factor for Temporomandibular joint ankylosis. Clinically the disease presents in the form of facial asymmetry, limitation of mouth opening, disturbed occlusion and sleep apnea while on radiographs, there is partial or complete loss of joint space, mushrooming of condyle, anti-gonial notch and coronoid hyperplasia

Frequency of unerupted mandibular third molar in mandibular angle fractures

Fractures of the mandibular angle are common and comprise 31% of all mandibular fractures. Multiple recent studies report a 2-3 fold increased risk for mandibular angle fractures when un-erupted mandibular third molars are present. The objective of this study was to assess the frequency of un-erupted mandibular third molar in mandibular angle fractures. This crosssectional study was conducted at the Department of Oral and Maxillofacial Surgery, Ayub Medical College, Abbottabad from April to October 2009. One hundred and two patients were included both from the outdoor and ward on consecutive non-probability sampling base. Data were recorded on a structured Performa and analysed using SPSS-16. A hemi-mandible containing un-erupted mandibular third molar was seen to have a 1.41 times the risk of mandibular angle fracture then a hemi-mandible containing an erupted mandibular third molar. The presence of unerupted mandibular third molar is associated with an increased risk for mandibular angle fracture.