Comprehensive analysis of patients with failure of mandibular hardware

The purpose of the study was to characterize patients who had failure of mandibular hardware (FMH).

This retrospective cohort study consisted of patients with mandible fractures (MFs) that required surgical intervention from 2012 to 2020. Patients were included when mandibular hardware failed. Descriptive variables were collected.

During the study period, 57 patients (47 male, average age 38.7 years) met the inclusion criteria. Incidence of FMH was 7.4%. Most patients were African American (n = 45, 78.9%) with American Society of Anesthesiologists classification II (n = 40, 70.2%). Tobacco use (n = 31, 54.4%) and/or alcohol (n = 33, 57.9%). The most common etiology was assault (n = 28, 49.1%). The most common location was the angle of the mandible. Most mandibles had fracture at 1 location (n = 31, 54.4%) and a tooth was involved in the fracture line (n = 44, 77.2%). More than half of patients were treated with transoral surgical approach (n = 35, 61.4%). The majority of patients received preoperative antibiotics (n = 51, 89.4%). Patients had varying levels of compliance with postoperative care, and most were not compliant. Infection (n = 45) was the most common presentation of FMH.

High American Society of Anesthesiologists score, smoking, excessive alcohol use, parafunctional habits, and compliance with postoperative instructions may affect surgical outcome.