Comparative Study of Maxillofacial Infections in Diabetic and Non-Diabetic Patients: A Prospective Comparative Study

Abstract

Infections of the maxillofacial anatomical spaces represent a critical clinical issue requiring early diagnosis, antibiotic therapy, and surgical intervention to control the source of infection. This prospective, comparative, observational study aims to evaluate the impact of diabetes mellitus on clinical manifestations, anatomical extent, laboratory inflammatory markers, treatment outcomes, and complications. The study included 70 patients at Zliten Medical Center (May 2022 – December 2025), divided into two equal groups (35 patients each): patients with diabetes and non-diabetic patients. Statistical analysis was performed using t-tests, the Mann-Whitney test, the chi-square test, and Fisher's exact test, with a significance level of p < 0.05. Key clinical and laboratory findings showed that the diabetic group had a significantly higher mean age (54.6 ± 10.5 vs. 41.9 ± 12.9 years; p < 0.001). Additionally, the incidence of involvement of multiple anatomical spaces was higher in diabetic patients, reaching 57.1% compared to 25.7% in non-diabetic patients (p = 0.015). The submandibular space was the most frequently affected area in both groups. Regarding inflammatory markers, diabetic patients exhibited a more intense inflammatory response, characterized by elevated white blood cell counts (15.9 ± 2.8 vs. 11.9 ± 2.5 × 10⁹/L; p < 0.001) and C-reactive protein levels (111.7 ± 44.5 vs. 69.8 ± 35.9 mg/L; p < 0.001). Cases involving diabetic patients required longer hospital stays (7.3 ± 1.9 vs. 4.8 ± 1.5 days; p < 0.001) and were associated with a higher rate of complications. Diabetes mellitus is linked to more severe and extensive maxillofacial infections, necessitating early diagnosis, decisive surgical intervention, and strict blood glucose control to minimize complications.