Case Report Accidental Intraoperative Mandibular Fracture in a Third Molar Surgery: When Surgical Skills Are Mandatory in the Face of Empiricism John Nadson Andrade Pinho , 1 Lucas Alves da Mota Santana , 1 Leandro Napier de Souza , 2 Paulo Nand Kumar , 3 Paulo Almeida Júnior , 3 and Liane Maciel de Almeida Souza 1,3 1 Department of Dentistry, Federal University of Sergipe (UFS), Aracaju, SE, Brazil 2 Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil 3 Department of Oral and Maxillofacial Surgery, Urgency Hospital of Sergipe (HUSE), Aracaju, SE, Brazil Correspondence should be addressed to Leandro Napier de Souza; leandronapierdesouza@gmail.com Received 30 January 2023; Revised 3 May 2023; Accepted 11 July 2023; Published 27 July 2023 Academic Editor: Rui Amaral Mendes Copyright © 2023 John Nadson Andrade Pinho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Iatrogenic mandible fractures are rare complications from third molar removal surgeries. While most documented cases stress risk factors inherent to the patient and tooth presentation in fractures’ etiology, appreciation of the risk factors underlying the practitioner’s skills is scarce. Here, we describe an intraoperative fracture in a healthy 26-year-old female resulting from an incompatible surgical technique during the right mandibular third molar removal. The patient showed facial swelling, pain, malocclusion, and significant mobility of the fractured segment. The surgical management involved an intraoral open reduction with the installation of titanium plates for the fixation of the bone segments. Thus, we highlight that acknowledging the extent of the operator’s surgical skills should be part of comprehensive treatment planning, serving as a valuable measure to prevent iatrogenic mandible fractures besides avoiding a traumatic experience for the patient. 1. Introduction Worldwide, third molar removal surgeries integrate many dentists’ routines, occasionally resulting in complications. Diverse reasons can be used to indicate third molar extractions, such as caries, mobility, cysts or tumor, periodontal problems, pericoronitis, and preparation for orthognathic surgery [1, 2]. However, compli- cations resulting from these interventions have been described in the literature, ranging from 3.47% to 9.1% second different sources [3, 4]. Among the most frequent complications reported are sec- ondary infection, alveolar osteitis, bleeding, and dysesthesia [5, 6]. Despite the low incidence of complications, a third molar sur- gery may also lead to a rare, but the most severe of the complications: the mandible fracture [6]. Associated with third molar surgeries, the incidence of mandible fractures is below 0.005% [6, 7]. Different from postoperative fractures, which occur within the first postoperative month, intraoperative fractures—also known as immediate fractures—occur specifically in the transoperatory [7–9]. Together with the clinical evaluation, observing the extent of the operator’s skills play a crucial role in comprehensive treat- ment planning and prevention of mandible fractures [6, 10]. Given the limited number of studies reporting iatrogenic mandible fractures and details of the mismanaged surgeries, the case presented herein aimed to describe an intraopera- tive fracture resulting from a lower mandibular third molar removal. The lack of comprehensive treatment planning and skills for the occurrence of this injury are also discussed. 2. Case Report A 26-year-old female was referred by a general practitioner to the Department of Oral and Maxillofacial Surgery of the Hindawi Case Reports in Dentistry Volume 2023, Article ID 2263554, 5 pages https://doi.org/10.1155/2023/2263554