Outcomes of patients with teeth in the line of mandibular angle fractures treated with stable internal fixation

Purpose: This study examines the relationship between postoperative infection and/or need for plate removal with the presence and management of teeth in the line of mandibular angle fractures. Methods: Data were collected on patients treated by intraoral open reduction and internal fixation for fractures of the mandibular angle during an 8-year period. Outcome variables were postoperative infection and need for removal of the bone plate(s). The relationships of demographic variables, teeth in the line of fracture, and management of teeth in the line of fracture were analyzed using standard statistical methods. Results: Four hundred two patients had sufficient follow-up for inclusion in the study. A tooth was present in the fracture line 85% of the time. Teeth in the fracture were removed in 75% of the fractures that contained teeth. Postoperative complications occurred in 19% of the sample. Fractures not containing teeth at the time of fracture had a 15.8% rate of postoperative infection compared with 19.1% for patients who had teeth in the fracture (P = NS). For angle fractures associated with a tooth, when the tooth was retained, the incidence of infection was 19.5%. When the tooth was removed, the incidence was 19.0% (P = NS). Conclusions: There is an increased risk for postoperative complications when a tooth is present, but the increase is not statistically significant. The incidence of postoperative infection and/or the need for plate removal is not affected by whether the tooth in the fracture is removed.