Surgical management of bilateral mandibular angle fracture following extraction of lower third molars

Abstract

Objective: Elucidate the treatment of a female patient who presented with bilateral mandibular angle fractures caused by third molar extraction during the transoperative period. Case details: A 24-year-old female patient was admitted to a tertiary hospital in Fortaleza, Brazil, with a history of complications during the extraction of lower third molars. Clinical and imaging examinations were performed to confirm the diagnosis. Surgical treatment was performed urgently under general anesthesia through bilateral posterior vestibular approaches, followed by open reduction and internal fixation using plates and screws. No complications were observed during the surgical procedure. At the 6-month postoperative follow-up, the patient showed no signs or symptoms of infection, no pain complaints, and no occlusal alteration. The fixation approach was based on the principle that at least one of the fractures required rigid fixation. Final considerations: Although this case appears to be unique in the literature, the patient presented with fractures in both mandibular angles at the same time. The surgical procedure resulted in good alignment of the fractured bone segments, stable occlusion, normal regional sensitivity, and adequate fixation, indicating that the technique employed was effective for the case reported.