The correlation between periodontal health status and suspectibility to infections associated with craniomaxillofacial osteosynthesis plates

J Craniomaxillofac Surg. 2017 Nov;45(11):1868-1874. doi: 10.1016/j.jcms.2017.08.018. Epub 2017 Aug 24.


Aim: The aim of the present study was to demonstrate the possible relation between periodontal health status and infections associated with osteosynthesis materials (OMs) used in the oral and maxillofacial reconstruction.

Material and methods: The study group consisted of 32 individuals which were subdivided into two groups regarding their PSI scores. After the removal of the osteosynthesis plates, microbial colonization was assessed via microbiological cultivation, fluorescence microscopy and scanning electron microscopy. In addition, samples obtained from gingival crevicular fluids were investigated by fluorescence microscopy.

Results: A total of 118 osteosynthesis plates were examined. 8.5% (n = 10) of the plates were associated at least one of the clinical signs of infection. There was a positive correlation between periodontal disease and clinical signs of infection (p = 0.022). Patients with infection signs also had a higher number of smoking history (pack years, p = 0.010). Intraorally placed osteosynthesis plates showed wide range of bacterial colonizations compared to extraorally inserted osteosynthesis materials (p = 0.004).

Conclusion: Patients with poor periodontal health might be potential candidates for OM related infections. Early removal of OMs in patients with poor periodontal health status and/or heavy smokers would have clinical benefits. In addition, preferation of extraoral access to the fracture line might decrease the possibility of plate related infections.

Keywords: Fluorescence; Infection; Microbiata; Osteosynthesis; Periodontitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Plates*
  • Disease Susceptibility
  • Female
  • Fracture Fixation, Internal / instrumentation*
  • Gingival Crevicular Fluid / microbiology
  • Health Status
  • Humans
  • Male
  • Maxillofacial Injuries / surgery*
  • Middle Aged
  • Oral Health*
  • Periodontitis / microbiology*
  • Prosthesis-Related Infections / microbiology*
  • Risk Factors
  • Skull Fractures / surgery*
  • Smoking / adverse effects
  • Young Adult