Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and maxillofacial surgeryPlate removal following orthognathic surgery
Section snippets
Material and Methods
Records for 570 consecutive patients operated between 2004 and 2009 were reviewed retrospectively (Table II). All patients had undergone either a bimaxillary, a Le Fort I, or bilateral sagittal split ramus osteotomies (BSSO) performed by 1 of the 3 senior staff members of the Department of Oral and Maxillofacial Surgery at St. John's Hospital in Genk. Records were included only of orthognathic patients for which the same operative technique and the same postoperative clinical attitude toward
Results
A total of 157 (27.5%) of the 570 patients had at least a portion of the hardware removed because they either requested removal or required removal secondary to complications related to the plates or screws. Of the 3197 plates that were placed, 622 (19.5%) were removed. The patients having hardware removal consisted of 115 females (31.7% of all female patients) and 42 males (20.3% of all male patients). This difference was significant (P = .0091).
In 78 patients (13.7%), the plates were removed
Discussion
Various complications can arise after miniplate and screw fixation, such as infection, miniplate fracture, nonunion, and mental nerve paralysis or dysesthesia.18 Plate removal after orthognathic surgery varies between 1.0% and 18.6% of patients.7, 8, 9, 10, 11 Some German centers advocate routine removal of titanium osteosynthesis material after treatment of fractures or operations for dysgnathia.4
Alpha et al.8 reported plate removal in only 10% of its BSSOs, although they described
Conclusions
This study reports an important percentage of patients (27.6%) developing complications from plates and screws that required their removal. Bimaxillary operations had higher removal rates than monomaxillary operations, and women were more likely to have their plates removed than men. Age had no significant influence on miniplate removal, except in some cases when an infectious episode caused the removals.
Almost 80% of the removed plates are removed within the first year. One of the advantages
References (30)
- et al.
Mandibular osteosynthesis by miniature screwed plates via buccal approach
J Maxillofac Surg
(1978) - et al.
The fate of miniplates in facial trauma and orthognathic surgery: a retrospective study
Br J Oral Maxillofac Surg
(1989) - et al.
Removal of miniplates in maxillofacial surgery: University Hospital Birmingham experience
J Oral Maxillofac Surg
(2003) - et al.
Removal of miniplates in maxillofacial surgery: a follow-up study
J Oral Maxillofac Surg
(2005) - et al.
Risk factors contributing to symptomatic plate removal following sagittal split osteotomy
Int J Oral Maxillofac Surg
(2006) - et al.
The incidence of postoperative wound healing problems following sagittal ramus osteotomies stabilized with miniplates and monocortical screws
J Oral Maxillofac Surg
(2006) - et al.
Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients
Int J Oral Maxillofac Surg
(2010) - et al.
The removal of plates and screws after le Fort I osteotomy
J Oral Maxillofac Surg
(1998) - et al.
Risk factors contributing to symptomatic plate removal in orthognathic surgery patients
J Oral Maxillofac Surg
(1999) - et al.
Occurrence of bad splits during sagittal split osteotomy
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2010)
Transoral placement of rigid fixation following sagittal ramus split osteotomy
J Oral Maxillofac Surg
Policy of consultant oral and maxillofacial surgeons towards removal of miniplate components after jaw fracture fixation: pilot study
Br J Oral Maxillofac Surg
Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-upPart I. Clinical parameters
Int J Oral Maxillofac Surg
One- or two-plate fixation of mandibular angle fractures?
J Craniomaxillofac Surg
Treatment methods for fractures of the mandibular angle
Int J Oral Maxillofac Surg
Cited by (50)
Quantifying bone healing after mandibular displacement in orthognathic surgery
2024, British Journal of Oral and Maxillofacial SurgeryRedefining our protocol of the orthognathic surgery-first approach after 10 years of experience
2022, British Journal of Oral and Maxillofacial SurgeryInfluence of different treatment procedures on the temporomandibular joint after mandibular setback in skeletal class III - A retrospective study
2022, Journal of Cranio-Maxillofacial SurgeryHigher need for removal of osteosynthesis material after multi-piece versus one-piece Le Fort I osteotomy: A retrospective study of 339 patients
2022, Journal of Cranio-Maxillofacial SurgeryPeri- and postoperative complications in Le Fort I osteotomies
2021, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :The fixation plates may have to be removed postoperatively for various reasons, such as infection, tenderness and pain, sinusitis, temperature sensitivity, palpability of plate, plate exposure, or patient request without complaints (Schmidt et al., 1998; Haraji et al., 2009; Little et al., 2015; Verweij et al., 2016). The plate removal rate has been reported to be between 2.0% and 24.6% (Ho et al., 2010; Falter et al., 2011; Verweij et al., 2016). In our study, the plate removal rate was 5.1%.
Complications Following One-Stage Versus Two-Stage Surgical Treatment of Transverse Maxillary Hypoplasia
2021, Journal of Oral and Maxillofacial Surgery