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Local radiation dose, fixation, and non-union of mandibulotomies
L E Smeele1, B J Slotman, J W Mens
1Department of Oral and Maxillofacial Surgery/Oral Pathology, Academic Hospital Vrije Universiteit/ACTA, Amsterdam, The Netherlands. le.smeels@azvu.nl
Unlabelled:
BACKGROUND. Non-union of mandibulotomies is a serious complication but risk factors are unclear. No data are available on the effect of the specific dose of irradiation at the osteotomy site.
Methods:
Forty-eight patients (36 men, 12 women, median age 58 years) undergoing a mandibulotomy and postoperative radiotherapy were enrolled in the study. Twenty-five had wire and 23 had plate osteosyntheses. Five patients had a non-union and three had minor complications. The distribution of the radiation dose and the specific dose at the mandibulotomy site were calculated. Parametric tests and logistic regression were used for analysis.
Results:
Non-union was not related to a specific dose of irradiation at the osteotomy site. Also, no effect could be attributed to type of fixation.
Conclusions:
There is no evidence for a single factor, radiation, or fixation type, that contributes to a non-union. We recommend a careful surgical technique.