Objectives
Mandibular osteomyelitis remains an incompletely understood entity, and treatment
of its various presentations remains diverse. The purpose of this study was to review
the necessity of antibiotic therapy after surgical treatment of mandibular osteomyelitis.
Study Design
A systematic review of published articles on surgical management of mandibular osteomyelitis
with or without postoperative antibiotic therapy was performed to answer the question,
“Does the use of postoperative antibiotics compared with surgery alone alter the success
rate in treating mandibular osteomyelitis?” The most recent evidence was sought by
searching PubMed, Embase, and Scopus databases. Article appraisal was performed by
2 reviewers.
Results
Forty-five articles were found that met the inclusion criteria, with all studies being
retrospective cohort or case series designs. Only 13 articles used Zurich classification
designations of acute osteomyelitis, secondary chronic osteomyelitis, or primary chronic
osteomyelitis, and the general heterogeneity of these articles made comparison difficult.
No study made an intentional statistical assessment of various antibiotic protocols.
Conclusions
Limited evidence suggested that resection may have better success rates than other
forms of surgical intervention, regardless of antibiotic therapy. This systematic
review questions the perceived necessity of intermediate- or long-term antibiotic
therapy in the management of mandibular osteomyelitis after surgical resection.
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Article info
Publication history
Published online: May 12, 2022
Accepted:
May 5,
2022
Received in revised form:
May 1,
2022
Received:
March 16,
2022
Identification
Copyright
Published by Elsevier Inc.
