하악 제3대구치의 존재여부 및 매복양상이 하악 우각부 골절과 과두 골절의 발생에 미치는 영향

The impact of the presence and aspect of mandibular third molars to the mandibular angle and condyle fractures

  • 이영주 (한림대학교 의과대학 구강악안면외과학 교실) ;
  • 송윤정 (한림대학교 의과대학 치과보존학 교실) ;
  • 홍순민 (뉴페이스 치과병원) ;
  • 채상식 (한림대학교 대학원 의학과) ;
  • 강현우 (한림대학교 대학원 의학과) ;
  • 최동주 (한림대학교 의과대학 구강악안면외과학 교실) ;
  • 박준우 (한림대학교 의과대학 구강악안면외과학 교실)
  • Lee, Young-Joo (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Song, Yun-Jung (Department of Operative dentistry, College of Medicine, Hallym University) ;
  • Hong, Soon-Min (Newface dental hospital) ;
  • Chae, Sang-Sik (Hallym university graduate school) ;
  • Kang, Hyeon-Woo (Hallym university graduate school) ;
  • Choi, Dong-Ju (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Park, Jun-Woo (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University)
  • 투고 : 2012.06.29
  • 심사 : 2012.08.13
  • 발행 : 2012.09.01

초록

Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.

키워드

참고문헌

  1. Kelly DE, Harrigan WF. A survey of facial fracture: Bdlevou hospital.1948-1974. J Oral Surg 1975;33(2):146-9.
  2. James RB, Fredrickson C, Kent JN. Prospective study of Mandibular fractures. J Oral Surg 1981;39(4):275-81.
  3. Ozkaya O, Turgut G, Kayali MU, U?urlu K, Kuran I, Ba? L. A retrospective study on the epidemiology and treatment of maxillofacial fractures. Ulus Travma Acil Cerrahi Derg. 2009;15(3):262-6.
  4. Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg 1990;48(9):926-32. https://doi.org/10.1016/0278-2391(90)90004-L
  5. Reitzik M, Lownie JF, Cleaton-jones P, Austin J. Experimental fractures of monkey mandibles. Int J Oral Surg 1978;7(2):100-3 https://doi.org/10.1016/S0300-9785(78)80054-4
  6. Lee JT, Dodson TB. The effect of mandibular third molar presence and position on the risk of an angle fracture. J Oral Maxillofac Surg 2000;58(4):394-8. https://doi.org/10.1016/S0278-2391(00)90921-2
  7. Tevepaugh DB, Dodson TB. Are Mandibular third molars a risk factor for angle fractures? A tertospective cohort study. J Oral Maxillofac Surg 1995;53(6):646-9. https://doi.org/10.1016/0278-2391(95)90160-4
  8. Oh SH. The role of mandibular third molar in the mandibular angle fractures. J Korean Assoc Maxillofac Plast Reconstr Surg 1998;20(3):207-13.
  9. Zhu SJ, Choi BH, Kim HJ, et al. Relationship between the presence of unerupted mandibular third molars and fractures of the mandibular condyle. Int J Oral Maxillofac Surg 2005 Jun;34(4):382-5 https://doi.org/10.1016/j.ijom.2004.10.002
  10. Iida S, Nomura K, Okura M, Kogo M. Influence of the incompletely erupted lower third molar on mandibular angle and condylar fractures. J Trauma. 2004;57(3):613-7. https://doi.org/10.1097/01.TA.0000096647.36992.83
  11. Weiss L. Static loading of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1965;19:253-62. https://doi.org/10.1016/0030-4220(65)90301-4
  12. Oh SH, Kim YG. Dynamic 3-dimensional finite element analysis of mandibular fracture mechanism. J Korean Assoc Maxillofac Plast Reconstr Surg 1996;18(3):470-87.
  13. Lee EW, Park HS. A clinical study on facial bone fractures of Koreans. J Korean Assoc Oral Maxillofac Surg 1983;9(1):99-114.
  14. Han IJ, Yoon JH. The clinical study on maxillofacial fractures of Korean. J Korean Assoc Oral Maxillofac Surg 1985;11(2):283-97.
  15. Dodson TB. Impacted third molar and mandibular angle fractures(letter). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;81(3):264. https://doi.org/10.1016/S1079-2104(96)80320-9
  16. Marker P, Eckerdal A, Smith-Sivertsen C. Incompletely erupted third molars in the line of mandibular fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(4):405-6. https://doi.org/10.1016/S1079-2104(05)80116-7
  17. Libersa P, Roze D, Cachart T, Libersa JC. Immediate and Late Mandibular Fractures After Third Molar Removal. J Oral Maxillofac Surg 2002;60(2):163-5. https://doi.org/10.1053/joms.2002.29811
  18. Duan DH, Zhang Y. Does the presence of mandibular third molars increase the risk of angle fracture and simultaneously decrease the risk of condylar fracture? Int J Oral Maxillofac Surg 2008;37(1):25-8. https://doi.org/10.1016/j.ijom.2007.07.010
  19. Cho SP, Lee JH, Kim CH. The influence of mandibular third molar on mandibular angle fracture. J Korean Assoc Maxillofac Plast Reconstr Sur 2006;28(1):49-57.
  20. Iida S, Hassfeld S, Reuther T, Nomura K, Muhling J. Relationship between the risk of mandibular angle fractures and the status of incompletely erupted mandibular third molars. J Craniomaxillofac Surg 2005;33(3):158-63. https://doi.org/10.1016/j.jcms.2004.12.001
  21. Safdar N, Meechan JG. Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995 ;79(6):680-4. https://doi.org/10.1016/S1079-2104(05)80299-9
  22. Halmos DR, Ellis E 3rd, Dodson TB. Mandibular third molars and angle fractures. J Oral Maxillofac Surg 2004;62(9):1076-81. https://doi.org/10.1016/j.joms.2004.04.012
  23. Liedholm R. Mandibular third molars: oral surgeons' assessment of the indications for removal. Br J Oral Maxillofac Surg. 1999;37(6):440-3. https://doi.org/10.1054/bjom.1999.0184