Infections are the most common complications following repair of mandibular fracture and is typically caused by the following:
Tooth in the line of fracture
A tooth in the fracture line that has root fractures or presents with periodontal disease may lead to contamination of the fracture site and should be treated or removed. Devital teeth in the fracture line should either be removed or treated endodontically.
Devitalized tissues in the line of fracture
Devitalized tissues such as fragments of necrotic bone, tooth fragments, or foreign bodies should be removed prior to reduction and fixation
Persistent instability due to inadequate fixation
Persistent instability leads to continuous interruption of the healing process, making the fracture site more susceptible for bacterial proliferation.
The same mechanism applies for the situation where mobility persists in the presence of inadequate osteosynthesis material.
If surgical treatment has to be delayed, the fracture should be immobilized until surgical treeatment can be performed.
Systemic pathological disorders
Pathological disorders impair immune system response and will increase the risk of infections. The most common systemic conditions leading to complications in fracture treatment are:
- Human immunodeficiency virus (HIV)
- Hypo and hyper thyroidism
- Chronic renal disease
- nutritional deficiency
Lack of antimicrobial therapeutics
Systemic antibiotics should be administered as soon as the fracture is diagnosed.