Distraction osteogenesis of the mandible: does postoperative infection affect stability?

Abstract

Background: Up to the present time, no study has attempted to explore a possible association between skeletal stability and postoperative infection in mandibular advancement by distraction osteogenesis.

Objectives: To determine any possible association between postoperative infection and skeletal stability of mandibular advancement by distraction osteogenesis for the treatment of Skeletal Class II patients.

Methods: Retrospective study of 20 Class II patients previously treated by distraction osteogenesis for mandibular advancement. Clinical records of these patients were reviewed and lateral cephalograms were used. Prevalence and duration of postoperative infection were recorded. Skeletal relapse was calculated based on serial hand tracings of lateral cephalograms. Statistical analysis of the data was performed to determine any association between prevalence and duration of postoperative infection and skeletal relapse.

Findings: 10 out of 20 patients presented with mild postoperative infection. None presented with more severe postoperative infections. All were treated with oral antibiotics and mouth rinse without surgical intervention. The percentage of horizontal relapse in patients with and without postoperative infections was 3.20% and 8.23% respectively (P > 0.05). When the duration of infection was plotted against the percentage of horizontal and vertical relapse, the relationship was weakly positive for both (R2 = 0.028 and 0.22, respectively).

Conclusions: It appears that mild postoperative infection does not affect postoperative skeletal stability in Class II patients treated with distraction osteogenesis of the mandible. Future studies with larger sample size and wider range of postoperative infections are needed to further elucidate if more severe postoperative infection would affect stability of the advancement.