Division of Medical Sciences at the Northern Ontario School of Medicine in Thunder Bay, Ontario, MS 3002, Canada.
Int J Oral Sci. 2011 Jul;3(3):160-4. doi: 10.4248/IJOS11058.
Orthognathic surgery is frequently accompanied by intermaxillary fixation. Intermaxillary fixation impedes the maintenance of effective oral hygiene and prolonged fixation can result in periodontal disease. A potential shorter term effect is the generation of oral malodour. It is unclear, however, as to how the production of malodorous compounds in the oral cavity is altered post-surgery. Oral air concentration of sulphur containing compounds, short chain organic acids, ammonia, isoprene and acetone were measured using selected ion flow tube-mass spectrometry in a patient who had undergone orthognathic surgery with subsequent intermaxillary fixation. Total sulphide levels rose approximately 5-fold during fixation with metal ties, with smaller increases recorded for the other compounds measured with the exception of isoprene which remained close to baseline levels. Organic acid levels declined markedly once elastic ties had replaced metal ties, with a lesser reduction being observed in sulphide levels, with both declining further after the commencement of a chlorhexidine-containing mouthwash. These data suggest that bacterial generation of a variety of malodorous compounds increases markedly following intermaxillary fixation. This single case also suggests that the use of elastic ties and effective oral hygiene techniques, including the use of chlorhexidine mouthwash, may help ameliorate such post-surgical effects.
正颌手术常伴有颌间固定。颌间固定妨碍有效口腔卫生的维持，长时间固定可导致牙周病。一个潜在的短期影响是产生口腔异味。然而，手术后口腔中恶臭化合物的产生如何变化尚不清楚。使用选择离子流管 - 质谱法测量了一位接受正颌手术和随后颌间固定的患者口腔空气中含硫化合物、短链有机酸、氨、异戊二烯和丙酮的浓度。用金属结扎固定时，总硫化物水平升高约 5 倍，除异戊二烯外，其他测量化合物的水平略有升高，异戊二烯仍接近基线水平。一旦弹性结扎取代金属结扎，有机酸水平显著下降，硫化物水平也略有下降，在使用含洗必泰的漱口液后进一步下降。这些数据表明，颌间固定后，细菌产生各种恶臭化合物的数量显著增加。这一单病例还表明，使用弹性结扎和有效的口腔卫生技术，包括使用洗必泰漱口液，可能有助于减轻这种术后影响。
