Associations between periodontitis and postoperative infectious complications in OSCC patients: a retrospective study

Periodontitis is a known risk factor for oral squamous cell carcinoma (OSCC), but its impact on postoperative outcomes remains unclear.

This retrospective study included 552 OSCC patients who underwent radical surgery with free flap reconstruction. Patients were classified into three groups: no periodontitis (N = 169), mild periodontitis (N = 148), and severe periodontitis (N = 235), based on preoperative computed tomography evaluations of alveolar bone and tooth loss. Data on demographics, surgical details, laboratory results, and complications were collected. Generalized estimating equations and multivariable regression analysis were used to evaluate the association between periodontal status and short-term postoperative outcomes.

Patients with mild or severe periodontitis had significantly higher risks of surgical site infection (SSI) (OR = 3.46, P = 0.012) and postoperative fever (OR = 10.93, P < 0.001). The average body temperature on the first three postoperative days (B = 0.22, P < 0.001), maximum temperature (B = 0.35, P < 0.001), and fever duration (B = 0.47, P < 0.001) were significantly higher in the periodontitis groups. Infection-related laboratory markers were consistently elevated within 1 week postoperatively in periodontitis patients (all P for trend < 0.05). Subgroup analysis revealed that the association between periodontitis and SSI was particularly pronounced in patients aged ≤ 60 years (OR = 4.12, P = 0.035), males (OR = 15.92, P = 0.010), those with longer operative durations (OR = 3.17, P = 0.019), smokers (OR = 27.93, P = 0.015), and patients without diabetes (OR = 3.85, P = 0.012).

The severity of periodontitis is significantly associated with postoperative infectious complications in OSCC patients. The management of periodontitis may be important in improving postoperative outcomes for OSCC surgery.