SynthesisFrontiers in oral health2026
Role of third molars in mandibular fractures: a systematic umbrella review with updated meta-analysis.
Synthesis in Frontiers in oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
Background and aims: Previous meta-analyses (MAs) and systematic reviews (SRs) reported that presence of third molars increases the risk of angle and decreases the risk of condylar fractures, but the data is dispersed across these studies. The aim of this umbrella review is to pool quantifiable data from the previous MAs. Methods: This umbrella review searched the PubMed, Embase and Web of Science databases through June 2026 in accordance with PRISMA recommendations. The MAs that looked at the relationships between third molars and mandibular fractures were included. The odds ratios (OR) and risk ratios (RR) for angle and condylar fractures were the main extraction data. The Newcastle-Ottawa Scale (NOS) criteria were applied for quality assessment and the GRADE tool was utilized to evaluate evidence certainty. Results: A total of 8 MAs with ∼40 thousand participants were included. Due to the high overlap across these MAs, only 32 unique primary studies were selected from these reviews. Further, an additional 10 studies were included from an independent literature search. In total, 42 studies encompassing ∼16 thousand participants were included for an updated meta-analysis. Third molars were associated with a significantly higher observed risk of mandibular angle fractures (RR 2.18, 95% CI 1.66-2.87, Conclusions: Third molars are associated with a higher observed risk of mandibular angle fractures, but they were associated with a lower observed risk of condylar fractures. Clinical decision on the prophylactic removal of the third molar should balance the risks of angle vs. condylar fractures. Definitive preventive strategies require well-designed prospective research. Systematic Review Registration: The protocol of this review is registered in PROSPERO database with the registration number of CRD420251121903.
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