Oral and Maxillofacial Surgery

, Volume 14, Issue 2, pp 71–80

Considerations of mandibular angle fractures during and after surgery for removal of third molars: a review of the literature

  • Bruno Ramos Chrcanovic
  • Antônio Luís Neto Custódio
Review Article

DOI: 10.1007/s10006-009-0201-5

Cite this article as:
Chrcanovic, B.R. & Custódio, A.L.N. Oral Maxillofac Surg (2010) 14: 71. doi:10.1007/s10006-009-0201-5



Angle fractures are quite common considering that the angle of the mandible forms an area of lower resistance which contains a thicker upper border, a thin basilar bone, and the presence of an impacted mandibular third molar. Common complications of mandibular third molar surgery include alveolar osteitis (dry socket), secondary infection, nerve dysfunction, and hemorrhage. Reports of mandibular fracture during and after third molar removal are uncommon.


The purpose of this paper is to discuss the risk and predisposing factors that should be analyzed regarding the possibility of immediate and late mandibular angle fractures and their need for surgical treatment as a means through which to remove impacted molars. This study is based on a thorough review of the literature as well as on one immediate and one late mandibular angle fracture as described by the authors’ own personal experience.


The danger of an immediate jaw fracture can be avoided by means of proper instrumentation and by refraining from excessive force on the bone. The tooth should be sectioned in such a way as to minimize the extent of bone removal and force caused by instrumentation. The danger of a late jaw fracture can be avoided by precise diagnosis in cases of patients over 25 years of age, particularly men, whose tooth roots are superimposed on or adjacent to the inferior alveolar canal on a panoramic image, any local pathology and systemic disease or medications which may impair bone strength, and patients who present bruxism and are active athletes.


Third molar surgery Complications Mandibular fracture 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Bruno Ramos Chrcanovic
    • 1
  • Antônio Luís Neto Custódio
    • 2
    • 3
    • 4
  1. 1.Belo HorizonteBrazil
  2. 2.Departamento de OdontologiaPontifícia Universidade Católica de Minas GeraisBelo HorizonteBrazil
  3. 3.Department of Oral and Maxillofacial Surgery, School of DentistryPontifícia Universidade Católica de Minas GeraisBelo HorizonteBrazil
  4. 4.Department of Morphology, Institute of Biological SciencesUniversidade Federal de Minas GeraisBelo HorizonteBrazil