Risk factors contributing to symptomatic plate removal following sagittal split osteotomy

doi:10.1016/j.ijom.2006.02.001

International Journal of Oral and Maxillofacial Surgery

Volume 35, Issue 7, July 2006, Pages 598-601

https://doi.org/10.1016/j.ijom.2006.02.001 Get rights and content

Abstract

The records of 80 consecutive patients (160 plates) undergoing orthognathic surgery over a 2-year period were analysed to assess the percentage of plate removal from the mandible following sagittal split osteotomy.

Factors considered in the study included age, sex, duration of operation, antibiotic prophylaxis regimen, general medical condition, smoking habits, mandibular moves, extraction of 3rd molars at time of surgery and the favourability of the mandibular splits.

Infection was the sole reason for plate removal in this study. A removal rate of 15.6% was noted. Age and duration of operation were the only 2 statistically significant factors to affect plate removal whilst some of the other factors showed increased odds ratios but were not statistically significant.

Section snippets

Materials and methods

Eighty consecutive patients’ records (21 males and 59 females) were reviewed. All patients had undergone either bimaxillary osteotomy or sagittal split ramus osteotomies in the Department of Oral and Maxillofacial Surgery at University College London Hospitals over a 2-year period between January 2001 and January 2003.

All procedures were carried out under general anaesthesia and all mandibular osteotomies were carried out in a normal standardized fashion and fixed with standard 4-hole straight

Results

Infection was the sole reason for plate removal in all patients. Out of the 160 plates placed in 80 patients, 25 plates (15.6%) were removed from 16 patients. The overall mean age was 25 years with an age range of 15–50 years. The mean age of the patients who underwent plate removal was 32 years (range 18–50 years). The female to male ratio in the study was 2.8:1. Of the 16 patients who underwent plate removal, 12 were female and 4 were male. Mean duration of operation was 180 min (range 70–305

Discussion

This study looked at 80 consecutive osteotomies carried out over a 2-year period and focused on a variety of potential risk factors involved in plate removal following bilateral sagittal split osteotomy, either as a stand-alone procedure or part of a bimaxillary osteotomy. The plate removal rate was recorded at 15.6%. It is important to note that plate removal is not synonymous with failure of treatment as all patients had their infected plates removed after a healing period that allowed bony

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Clinical PaperOrthognathic SurgeryRisk factors contributing to symptomatic plate removal following sagittal split osteotomy