Abstract
Mandibular fractures following extraction of impacted mandibular third molars are rare but represent a serious complication associated with functional impairment. We report two cases of mandibular fractures occurring after extraction. Case 1 involved a 49-year-old male. A left mandibular fracture developed during eating 10 days after bilateral maxillary and mandibular impacted third molar extractions. Open reduction and internal fixation was performed 122 days post-extraction. Case 2 involved a 69-year-old male. A left mandibular fracture occurred during eating 11 days after extraction of a left mandibular third molar. Due to malocclusion, open reduction and internal fixation was performed 18 days post-extraction. Both cases involved middle-aged to elderly males with a clenching habit.
Occlusal force measurements exceeded the average in both cases, with Case 1 showing a particularly high value of approximately 2.7 times the mean. Contributing factors to the fractures included excessive occlusal forces, a clenching habit, and loss of the tension band due to mandibular crest reduction involving the external oblique line. To prevent post-extraction fractures, it is crucial to minimize external oblique line reduction and to instruct patients to consume soft foods for at least three weeks post-operatively.
