Titanium miniplate removal after joint orthodontic-orthognathic surgery treatment: A 10-year retrospective hospital-based audit

Adatia, A; Padashi-Fard, M; Adali, N S; Camilleri, A C

Titanium miniplate removal after joint orthodontic-orthognathic surgery treatment: A 10-year retrospective hospital-based audit

Authors

Adatia, A

Padashi-Fard, M

Adali, N S

Camilleri, A C

Issue Date

2022

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Surgery , Research Subject Categories::ODONTOLOGY

Abstract

Abstract Introduction: The reported incidence of titanium miniplate removal after orthognathic surgery varies widely, making delivery of risk information to patients problematic. This variation relates to potential biases introduced during the study design, for example, with the pooling of different patient types, creating heterogeneous study samples. This study reduces sampling bias by limiting the cohort to only consecutive orthognathic cases. The primary aim of the study was to identify the incidence of miniplate removal following orthognathic surgery. The secondary aim was to assess the indications and any risk factors for miniplate removal. Methods: Data from the clinical records of 907 orthognathic surgery cases treated within a centralised oral and maxillofacial hospital service over a 10-year period were collected by two operators and analysed. Every identified case qualified for inclusion. Patient demographics (age, sex, medical comorbidity, smoking), operations (type of surgery, duration, third molar removal, complications) and the indication, timing and site of miniplate removal were analysed. Results: Only 19 patients required postoperative miniplate removal, with the most common indication being infection (63%). There was no significant difference in any of the factors assessed except that significantly more miniplates were removed from female patients (68%) (p<0.001) and from mandibular sites (84.2%) (p=0.003). Conclusions: The incidence of miniplate removal for this sample was 2.1%. Female sex and miniplate location in the mandible were the only statistically significant risk factors for miniplate removal. Keywords: Miniplate removal; Miniplates; Orthognathic surgery; Osteotomy; Postoperative complication; Titanium miniplates. PubMed Disclaimer Similar articles Maxillofacial Trauma Surgery Patients With Titanium Osteosynthesis Miniplates: Remove or Not? Sukegawa S, Masui M, Sukegawa-Takahashi Y, Nakano K, Takabatake K, Kawai H, Nagatsuka H, Furuki Y. J Craniofac Surg. 2020 Jul-Aug;31(5):1338-1342. doi: 10.1097/SCS.0000000000006352. PMID: 32371694 Is the removal of osteosynthesis plates after orthognathic surgery necessary? Retrospective long-term follow-up study. Sukegawa S, Kanno T, Manabe Y, Matsumoto K, Sukegawa-Takahashi Y, Masui M, Furuki Y. Int J Oral Maxillofac Surg. 2018 Dec;47(12):1581-1586. doi: 10.1016/j.ijom.2018.07.001. Epub 2018 Jul 23. PMID: 30049607 Resorbable versus titanium plates for orthognathic surgery. Agnihotry A, Fedorowicz Z, Nasser M, Gill KS. Cochrane Database Syst Rev. 2017 Oct 4;10(10):CD006204. doi: 10.1002/14651858.CD006204.pub3. PMID: 28977689 Free PMC article. Review. Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients. Kuhlefelt M, Laine P, Suominen-Taipale L, Ingman T, Lindqvist C, Thorén H. Int J Oral Maxillofac Surg. 2010 May;39(5):430-5. doi: 10.1016/j.ijom.2010.01.016. Epub 2010 Feb 23. PMID: 20181459 Resorbable versus titanium plates for orthognathic surgery. Fedorowicz Z, Nasser M, Newton JT, Oliver RJ. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD006204. doi: 10.1002/14651858.CD006204.pub2. Update in: Cochrane Database Syst Rev. 2017 Oct 04;10:CD006204. doi: 10.1002/14651858.CD006204.pub3. PMID: 17443617 Review. See all similar articles References Kuhlefelt M, Laine P, Suominen-Taipale Let al. . Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients. Int J Oral Maxillofac Surg 2010; 39: 430–435. - PubMed Champy M, Loddé JP, Schmitt Ret al. . Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 1978; 6: 14–21. - PubMed Cawood M. Small plate osteosynthesis of mandibular fractures. Br J Oral and Maxillofac Surg 1985; 23: 77–91. - PubMed O’Connell J, Murphy C, Ikeagwuani Oet al. . The fate of titanium miniplates and screws used in maxillofacial surgery: a 10 year retrospective study. Int J Oral Maxillofac Surg 2009; 38: 731–735. - PubMed Ward Booth P. Discussion: risk factors contributing to symptomatic plate removal in orthognathic surgery patients. J Oral Maxillofac Surg 1999; 57: 682. - PubMed Show all 18 references MeSH terms Bone Plates* / adverse effects Device Removal / adverse effects Female Hospitals Humans Orthognathic Surgery* Retrospective Studies Titanium Substances Titanium Related information PubChem Compound (MeSH Keyword) LinkOut - more resources Full Text Sources Atypon Europe PubMed Central Ovid Technologies, Inc. PubMed Central

Citation

Adatia A, Padashi-Fard M, Adali NS, Camilleri AC. Titanium miniplate removal after joint orthodontic-orthognathic surgery treatment: a 10-year retrospective hospital-based audit. Ann R Coll Surg Engl. 2022 Jul;104(7):525-529. doi: 10.1308/rcsann.2021.0229. Epub 2022 Jan 6. PMID: 34989628; PMCID: PMC9246547.