Correlation of gonial angle and ramal height with the prevalence of mandibular fractures:A clinico-radiographic study

Angle of the mandible is the transition zone between dentate and edentate regions, and is commonly associated with impacted teeth. In case of completely impacted third molar, the widest portion of tooth is generally found below the external oblique ridge. However, tension line will be distrupted when tooth is partially impacted, thus weaken the mandibular angle and make it more susceptible to fracture. The objective of this study was to ascertain the impact of Gonial Angle size, Ramal Height, Occlusal Support, Status and Position of mandibular third molar on the location of mandibular fracture in 120 patients with preoperative digital orthopantomograms. Majority of fractures occurred in male patients with no significant difference at different fracture sites of mandible (p=0.9688).There was no correlation of age, gender, mechanism of injury and occlusal support with gonial angle and ramal height in all patients with mandibular fractures. There was significant difference in the status (p=0.0361) and horizontal position (p=0.0092) of mandibular third molar at different fracture sites of mandible. Third molars were present in 88.88% patients of angle fractures versus 62.96% in patients with condyle fractures. In conclusion, higher gonial angle and short ramus height are the main risk factors in mandibular angle fractures. Also, presence and absence of third molar tends to increase the susceptibility of mandible fracture particularly at angle and condyle region respectively.