Infection after maxillofacial trauma remains an important complication, with a significant socio-economic impact. While consensus exists that systemic antibiotic prophylaxis reduces the risk of infection in the management of maxillofacial fractures, the type, and duration remain controversial. Therefore, the purpose of this scoping review was to provide an overview of the current evidence that supports the use of prophylactic antibiotics in the treatment of maxillofacial fractures. A comprehensive literature search on 1 January 2022, in PubMed, Web of Science, Embase, and Cochrane, revealed 16 articles. Most studies focused on the duration of systemic antibiotic prophylaxis and compared a one-day to a five-day regimen. Included studies showed considerable variability in design and research aims, which rendered them difficult to compare. Furthermore, a variety of antibiotic regimens were used, and most studies had a short follow-up period and unclear outcome parameters. This scoping review demonstrates the lack of well-constructed studies investigating the type and duration of systemic antibiotic prophylaxis in the treatment of maxillofacial trauma. Based on the included articles, prolonging antibiotic prophylaxis over 24 h for surgically treated fractures does not appear to be beneficial. Furthermore, there is no evidence for its use in conservatively treated fractures. These results should be interpreted with caution since all included studies had limitations.

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Aim: An odontogenic keratocyst (OKC) of the mandible is a benign intraosseus lesion of odontogenic origin characterized by a high recurrence rate. In this case report, we highlight the challenging diagnosis and propose a potential treatment for an extensive OKC with lingual expansion. Summary: A 26-year-old male with an OKC in the ramus of the right mandible near the second and third molars was treated by a combined intra/extra-oral approach. A reconstruction plate was adapted and fixed by extra-oral submandibular access, followed by intra/extra-orally executed enucleation. Key learning points: The combined intra/extra oral approach seems a reasonable technique for the treatment of similar extensive OKC's in order to avoid pathological fractures as well as guaranteeing total removal of the lesion.