Infected screws in patients treated by mandibular sagittal split osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Complications
• Dental Implantology

Background:

• Mandibular sagittal split osteotomy is a common procedure for correcting jaw discrepancies.
• Third molar (wisdom tooth) removal is frequently performed, sometimes concurrently with other oral surgeries.
• Hardware infection and exposure are potential complications following rigid fixation in osteotomy procedures.

Purpose of the Study:

• To investigate the association between simultaneous third molar extraction and the incidence of hardware infection or exposure after mandibular sagittal split surgery.
• To determine if concurrent removal of wisdom teeth impacts complication rates in this patient population.

Main Methods:

• A retrospective review of 83 patients who underwent mandibular sagittal split surgery between July 1987 and July 1991.
• Patients were categorized based on whether third molars were extracted during the sagittal split procedure.
• Infection and hardware exposure rates were compared between the groups.

Main Results:

• Fifteen out of 83 patients experienced hardware infection or exposure.
• A significantly higher proportion of patients with complications (73.3%) had undergone third molar extraction during the surgery compared to the uncomplicated group (38.2%).
• The observed difference in complication rates was statistically significant (P < .05).

Conclusions:

• Simultaneous extraction of third molars during mandibular sagittal split surgery is strongly associated with an increased risk of hardware infection and exposure.
• To mitigate these risks, it is advisable to perform third molar extractions well in advance of the sagittal split osteotomy.
• This proactive approach can help reduce the incidence of post-surgical complications.