Is Plate Removal after Orthognathic Surgery Mandatory?

Dinesh Ram Raja.A.V^1, , Madhulaxmi. M², P.U. Abdul Wahab² and James Solomon Jesudasan²

¹Department of Oral Surgery, Saveetha Dental College, Chennai, India

²Department of Oral and Maxillo facial surgery, Saveetha Dental College, Chennai

Cite this paper:
Dinesh Ram Raja.A.V, Madhulaxmi. M, P.U. Abdul Wahab and James Solomon Jesudasan. Is Plate Removal after Orthognathic Surgery Mandatory?. International Journal of Dental Sciences and Research. 2013; 1(3):60-62. doi: 10.12691/ijdsr-1-3-5

Abstract

Rigid internal fixation was propagated for use in the oral and maxillofacial region in the late 197Os. Since that time, a number of systems have been developed for orthognathic surgery, craniofacial surgery and facial fracture reconstruction [1,2]. The advantages of such internal fixation include a stable intra operative maxillary position, the avoidance or reduced time of maxillomandibular fixation, and the suggestion within the current literature that long term stability is improved [3,4,5,6]. In most maxillofacial units it is routine policy not to remove plates and screws following bony union, unless when clinically indicated [7,8,9]. Many studies have investigated the removal of miniplates in trauma cases but relatively few studies have focused exclusively on orthognathic surgery operations. This review of literature was done to investigate if there isa need and necessity to remove plates and screws after orthognathic surgery.

Keywords:
miniplates orthognathic surgery infection

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Champy M, Lodde JP, Schmidt R, et al: Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 6: 14, 1978.
[2]	Brian L. Schmidt, David H. Perrott, Dennis Mahan and Gerard Kearns: The Removal of Plates and Screws after Le Fort I Osteotomy. J Oral Maxillofac Surg 56.184-188, 1998.
[3]	Horster W: Experience with functionally stable plate osteosynthesis after forward displacement of the upper jaw. J MaxillofacSurg 8: 176,1980.
[4]	Rittersma J, van der Veld RGM, van Gool AV, et al: Stable fragment fixation in orthognathic surgery: Review of 30 cases. J Oral Surg 39:671, 1981.
[5]	Steinhauser EW: Bone screws and plates in orthognathic surgery. Int J Oral Surg 11:209, 1982.
[6]	Egbert M, Hepworth B, Myall R, et al: Stability of Le Fort I osteotomy with maxillary advancement: A comparison of combined wire fixation and rigid fixation. J Oral Maxillofac Surg 53:243, 1995.
[7]	Matthew IR, Frame JW: Policy of consultant oral & maxillofacial surgeons towards removal of miniplate components after jaw fracture fixation–A pilot study. Br J Oral Maxillofac Surg 37: 110, 1999.
[8]	Brown JS, Trotter M, Cliffe J, et al: The fate of miniplates in facial trauma and orthognathic surgery: A retrospective study. Br J Oral Maxillofac Surg 27:306, 1989.
[9]	Haug RH: Retention of asymptomatic bone plates used for orthognathic surgery and facial fractures. J Oral Maxillofac Surg 54:611, 1996.
[10]	Ward Booth P: Discussion: Risk factors contributing to symptomatic plate removal in orthognathic surgery patients. J Oral Maxillofac Surg 57:682, 1999.
[11]	Vyomesh Bhatt, Purnima Chhabra, M.S. Dover:Removal of Miniplates in MaxillofacialSurgery: A Follow-Up Study. American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 63:756-760, 2005.
[12]	Persson G, Hellem S, Nord PG: Bone plates for stabilising Le Fort I osteotomies. J Maxillofac Surg 14:69, 1986.
[13]	Punnia-Moorthy A, Rix L, Stevenson L: An analysis of 80 cases of mandibular fractures treated with miniplate osteosynthesis. Int J Oral Maxillofac Surg 20:337, 1991 BHATT, CHHABRA, AND DOVER 759.
[14]	Francel TJ, Birely BC, Ringelmann PR, et al: The fate of plates and screws after facial fracture reconstruction. Plast Reconstr Surg 90:568, 1992
[15]	Nakamura S, Oka M, Takenoshita Y: Complications of miniplate osteosynthesis for mandibular fractures. J Oral Maxillofac Surg 52:233, 1994.
[16]	Alpert B, Seligson D. Removal of asymptomatic bone plates used for orthognathic surgery and facial fractures. J Oral Maxillofac Surg 1996; 54:618-21.
[17]	Schmidt BL, Perrott DH, Mahan D, et al: The removal of plates and screws after Le Fort I osteotomy. J Oral Maxillofac Surg 56:184, 1998.
[18]	Manor Y, Chaushu G, Taicher S: Risk factors contributing to symptomatic plate removal in orthognathic surgery. J Oral Maxillofac Surg 57:679, 1999.
[19]	Bhatt V, Langford RJ: Removal of miniplates in maxillofacial surgery: University Hospital Birmingham experience. J Oral Maxillofac Surg 61:553, 2003.
[20]	T. Theodossy, O. Jackson, A. Petrie, T. Lloyd: Risk factors contributing to symptomatic plate removal following sagittal split osteotomy. Int. J. Oral Maxillofac. Surg. 2006; 35: 598-601.
[21]	Bart Falter,Serge Schepers,Luc Vrielinck,Ivo Lambrichts and Constantinus Politis:Plate removal following orthognathic surgery.Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:737-743.
[22]	Alpha C, O’Ryan F, Silva A, Poor D. The incidence of postoperative wound healing problems following sagittal ramus osteotomies stabilized with miniplates and monocortical screws. J Oral Maxillofac Surg 2006; 64:659-68.
[23]	Kuhlefelt M, Laine P, Suonimen-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; 39:430-5.
[24]	Beals SP, Munro IR. The use of miniplates in craniomaxillofacial surgery. Plast Reconstr Surg 1987; 79:33-8.
[25]	Mueller CK, Bader RD, Schultze-Mosgau S. Oral and maxillofacial injuries. Current concepts of treatment. Trauma Berufskrankh 2010; 12:208-14.
[26]	Baqain ZH, Hyde N, Patrikidou A, Harris M. Antibiotic prophylaxis for orthognathic surgery: a prospective randomised clinical trial. Br J Oral Maxillofac Surg 2004: 42: 506-510.
[27]	Ruggles JE, Hann JR. Antibiotic prophylaxis in intraoral orthognathic surgery. J Oral Maxillofac Surg 1984: 42: 797-801.
[28]	Haug RH. Retention of asymptomatic bone plates used for orthognathic surgery and facial fractures. J Oral Maxillofac Surg 1996; 54:611-7.
[29]	Rubio J, Garcia-Alonso M, Alonso C, Alobera M, Clemente C, Munuera L, et al. Determination of metallic traces in kidneys, livers, lungs and spleens of rats with metallic implants after a long implantation time. J Mater Sci Mater Med 2008; 19:369-75.
[30]	Sarmiento-González A, Encinar J, Marchante-Gayón J, Sanz- Mendel A. Titanium levels in the organs and blood of rats with a titanium implant, in the absence of wear, as determined by double-focusing ICP-MS. Anal Bioanal Chem 2009;393:335-43.
[31]	Langford RJ, Frame JW: Surface analysis of titanium maxillofacial plates and screws retrieved from patients. Int J Oral Maxillofac Surg 31:511, 2002.