Bacteremia after plate removal and tooth extraction

Our aim was to investigate the occurrence of bacteremia associated with removal of a semirigid osteosynthesis plate and an adjacent third molar. Ten patients with fixed mandibular angle fracture were bacteriologically sampled from the second molar's distal gingival pocket, from the third molar's extraction socket and from the osteosynthesis plate. Blood samples from the ante-cubital vein were taken 10 times until 30 min postoperatively. Established culture, isolation and identification methods for the bacterial species were used. Bacteremia was detected in 60% of the subjects, most frequently 1.5 min after removal of the plate (20%) and 1.5 and 5 min after extraction of the tooth (20%), but also 10 min (10%) and 30 min (10%) postoperatively. 13 different bacterial species or groups were isolated, mean 2.5 +/- 1.9 per bacteremia-positive subject. The majority (85%) were anaerobes with Actinomyces, Campylobacter and Lactobacillus species predominating. In all the blood culture-positive cases the corresponding species was also recovered from one or more of the oral samples. These results show that oral surgical procedures are associated with a high frequency of longstanding anaerobic bacteremia, which could be harmful in patients at risk.