Is Mini-Plate Removal Necessary for Oral and Maxillofacial Surgery Patients? A Five-Year Case-Control Study
Objectives: The purpose of this study was to determine the mini-plate and screw removal rate and reasons in maxillofacial surgery patients under previous semi-rigid fixation treatment in the past five years at the main trauma center of Mashhad.
Materials and Methods: This was a census-based retrospective study. All the candidates who admitted to our department for maxillofacial plate removal due to symptomatic or infected mini-plates were included in this study. The patients’ age and gender, plate removal etiologies, and the time between plate insertion and removal were analyzed.
Results: Mini-plates were inserted for 1026 patients. However, only 94 patients with a mean age of 29.4±11.1 years were candidates for plate removal. The plate removal rate was 9.16%. Infection and exposure were the most common causes of plate removal. The most prevalent removal site was the mandible (angle and body). The interval between mini-plate insertion and removal was an average of 12.9±5.6 months. It is noteworthy that the shortest lasting duration was when plate removal was secondary to pain (6.67 months) and infection (11.45 months).
Conclusion: This research showed that the routine removal of plates does not appear to be generally indicated in healthy subjects unless there is an obvious and definitive clinical indication.
2. Islamoglu K, Coskunfirat OK, Tetik G, Ozgentas HE. Complications and removal rates of miniplates and screws used for maxillofacial fractures. Ann Plast Surg. 2002 Mar;48(3):265-8.
3. Park HC, Kim SG, Oh JS, You JS, Kim WG. Mini-plate removal in maxillofacial trauma patients during a five-year retrospective study. J Korean Assoc Oral Maxillofac Surg. 2016 Aug;42(4):182-6.
4. Thorén H, Snäll J, Kormi E, Lindqvist C, Suominen-Taipale L, Törnwall J. Symptomatic plate removal after treatment of facial fractures. J Craniomaxillofac Surg. 2010 Oct;38(7):505-10.
5. Bhatt V, Chhabra P, Dover MS. Removal of miniplates in maxillofacial surgery: A follow-up study. J Oral Maxillofac Surg. 2005 Jun;63(6):756-60.
6. Rallis G, Mourouzis C, Papakosta V, Papanastasiou G, Zachariades N. Reasons for miniplate removal following maxillofacial trauma: a 4-year study. J Craniomaxillofac Surg. 2006 Oct;34(7):435-9.
7. Bhatt V, Langford RJ. Removal of miniplates in maxillofacial surgery: University Hospital Birmingham experience. J Oral Maxillofac Surg. 2003 May;61(5):553-6.
8. Rauso R, Tartaro G, Stea S, Tozzi U, Biondi P. Plates removal in orthognathic surgery and facial fractures: When and why. J Craniofac Surg. 2011 Jan;22(1):252-4.
9. Thorén H, Snäll J, Hallermann W, Kormi E, Törnwall J. Policy of routine titanium miniplate removal after maxillofacial trauma. J Oral Maxillofac Surg. 2008 Sep;66(9):1901-4.
10. Champy M, Loddé JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978 Feb;6(1):14-21.
11. Kent SJW, Al-Izzi T, Herbert C, Ryan M. A Retrospective Review of Metal Plate Removal in an Oral and Maxillofacial Surgery Department. Int J Dent Sci Res. 2017;5(1):5-8.
12. Pan Z, Patil PM. Titanium osteosynthesis hardware in maxillofacial trauma surgery: to remove or remain? A retrospective study. Eur J Trauma Emerg Surg. 2014 Oct;40(5):587-91.
13. Rana ZA, Khoso NA, Siddiqi KM, Arshad O, Farooq MU. The incidence and indications for removal of osteosynthesis devices in adult Trauma patients: A retrospective study. Ann Pak Inst Med Sci. 2012;8(3):184-7.
14. Little M, Langford RJ, Bhanji A, Farr D. Plate removal following orthognathic surgery. J Craniomaxillofac Surg. 2015 Nov;43(9):1705-9.
15. Manor Y, Chaushu G, Taicher S. Risk factors contributing to symptomatic plate removal in orthognathic surgery patients. J Oral Maxillofac Surg. 1999 Jun;57(6):679-82.
16. Matthew IR, Frame JW. Policy of consultant oral and maxillofacial surgeons towards removal of miniplate components after jaw fracture fixation: pilot study. Br J Oral Maxillofac Surg. 1999 Apr;37(2):110-2.
17. Nagase DY, Courtemanche DJ, Peters DA. Plate removal in traumatic facial fractures: 13-year practice review. Ann Plast Surg. 2005 Dec;55(6):608-11.
18. Haraji A, Motamedi MH, Moharamnejad N. Causes and incidence of miniplate removal following Le Fort I osteotomy. Eplasty. 2009 Oct 12;9:e45.
19. Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, et al. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22(5):e616-e624.
20. Kuhlefelt M, Laine P, Suominen-Taipale L, Ingman T, Lindqvist C, Thorén H. Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients. Int J Oral Maxillofac Surg. 2010 May;39(5):430-5.
21. Bakathir AA, Margasahayam MV, Al-Ismaily MI. Removal of bone plates in patients with maxillofacial trauma: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 May;105(5):e32-7.
22. Yamamoto K, Matsusue Y, Horita S, Murakami K, Sugiura T, Kirita T. Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line. Ann Maxillofac Surg. 2015 Jan-Jun;5(1):77-81.
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