Osteomyelitis after bilateral sagittal split osteotomy: case report and a review of the management

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Apr;111(4):442-8. doi: 10.1016/j.tripleo.2010.06.003. Epub 2010 Oct 16.

Abstract

Objectives: The purpose of this paper is to report a case of osteomyelitis following a bilateral sagittal split osteotomy in a patient who underwent 2-jaw surgery. A review of the management of osteomyelitis is included, with a discussion of implications for the reconstruction of the mandible after treatment for osteomyelitis.

Study design: A case of a rapidly progressing osteomyelitis is presented with a detailed review of the management of osteomyelitis, using this case to illustrate key points of management.

Results: In a very short period of time the patient lost a significant portion of the left side of her mandible. The actual management that she underwent, as well as some of the controversies that are present with the treatment of osteomyelitis, is discussed.

Conclusion: Although osteomyelitis of the mandible usually is seen after odontogenic infections and trauma, it can occur in patients undergoing elective osteotomies. When recognized, it should be aggressively treated.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Bone Plates
  • Bone Screws
  • Clindamycin / administration & dosage
  • Drainage
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / surgery
  • Ertapenem
  • Female
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / surgery
  • Humans
  • Jaw Fixation Techniques / adverse effects*
  • Jaw Fixation Techniques / instrumentation
  • Mandible / surgery*
  • Ofloxacin / administration & dosage
  • Open Bite / surgery
  • Orthognathic Surgical Procedures / adverse effects*
  • Osteomyelitis / drug therapy
  • Osteomyelitis / etiology*
  • Osteomyelitis / surgery
  • Osteotomy / adverse effects
  • Osteotomy, Le Fort
  • Retrognathia / surgery
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / surgery
  • beta-Lactams / administration & dosage

Substances

  • Anti-Bacterial Agents
  • beta-Lactams
  • Clindamycin
  • Ofloxacin
  • Ertapenem