Bacteremia after piezocision

Am J Orthod Dentofacial Orthop. 2014 Oct;146(4):430-6. doi: 10.1016/j.ajodo.2014.06.009.

Abstract

Introduction: The aim of this study was to investigate the presence of transient bacteremia after a piezocision procedure.

Methods: The sample consisted of 30 subjects (24 women, 6 men; mean age, 19.6 ± 0.7 years; range, 18.1-22.4 years) with the American Society of Anesthesiologists' physical status I. All patients had Class I skeletal and dental relationships and had fixed orthodontic treatment with the Damon system. The piezocision surgery was performed 1 week after the placement of the orthodontic appliances in all patients. Two 20-mL venous blood samples were collected before and 30 to 60 seconds after the first microincision using an aseptic technique. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were assessed in the BACTEC blood culture analyzer (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md). The results were analyzed statistically using the McNemar test, with P <0.05 indicating statistical significance.

Results: No significant difference between the preoperative and postoperative samples was determined with respect to transient bacteremia (P = 0.250). No bacteremia was detected in the pretreatment samples, although Gemella sanguinis, Streptococcus pluranimalium, and Streptococcus mitis/oralis were detected in 3 postoperative blood samples.

Conclusions: The piezocision procedure might be related to transitory bacteremia. Hence, orthodontists should consider the possibility of bacterial endocarditis in at-risk patients when piezocision is part of the treatment plan.

MeSH terms

  • Adolescent
  • Bacteremia / microbiology*
  • Bacteriological Techniques
  • Cohort Studies
  • Female
  • Gemella / isolation & purification
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Male
  • Malocclusion, Angle Class I / surgery*
  • Malocclusion, Angle Class I / therapy
  • Orthodontic Appliances
  • Osteotomy / methods*
  • Piezosurgery / methods*
  • Prospective Studies
  • Streptococcus / classification
  • Streptococcus mitis / isolation & purification
  • Streptococcus oralis / isolation & purification
  • Tooth Movement Techniques / instrumentation
  • Young Adult