Miniplate removal in operated cases of maxillofacial region in a dental institute in Rajasthan, India

Abstract

BackgroundThe long term management of miniplate fixation osteosynthesis remains debatable and controversial with few authors advocating routine removal of the miniplates after 3–6 months of placement, while others recommend retention of the miniplates unless their removal is clinically indicated.ObjectiveThe aim was to study the incidence, indications, time gap, role of metallic composition and site of removal of miniplates in operated cases of maxillofacial region over a two-year period.MethodsPatients undergoing removal of miniplates over 2-year period were studied and evaluated regarding the number of miniplates removed, time gap present between fixation and removal of miniplates, indications for removal, metallic composition of miniplates removed, sites of removal and complications. Correlations between indications for miniplate removal based upon time gap, metallic composition, age group and number of miniplates present were determined using Chi-square test. Correlation between metallic composition of miniplate and time gap was also determined using Chi-square test.ResultsThe miniplates were removed in 20 patients (16 males and 4 females). Most common indication for removal was infection (45%). Forty-five percent of the patients underwent miniplate removal within 1 year of placement. Thirty-four miniplates and 118 screws were removed. The correlation between indications for miniplate removal and time gap was found to be statistically significant (P = 0.04).ConclusionMost of the hardware removal is performed subsequent to complications associated with hardware and local factors play more important role than metallic composition. Routine asymptomatic miniplates do not require removal and is not recommended.

Compositional and surface changes of retrieved stainless-steel hardware and its effects on surrounding soft tissues: A prospective study

“…A few studies reported that the majority of the patients underwent hardware removal during the first year, while a few studies reported that most patients required hardware removal within 6 months following surgery. [ 13 16 17 ] It is advocated that the hardware removal is easier within 6 months following surgery and with an increase in time, it would become difficult to remove the hardware, particularly in young patients in whom the hardware is often covered by bone. [ 16 ] A previous study revealed that a residual granulation tissue forms around long-standing hardware which becomes necrotic, leading to long-standing inflammation and necrosis.…”

Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis

“…Miniplate removal should primarily address miniplate-related symptoms. While some authors advocate routinely removing miniplates to avert interference with jaw function and osteoporosis, most studies suggest removal only when symptoms manifest and discourage the routine removal of asymptomatic miniplates [12,[41][42][43][44][45][46][47][48][49].…”

Miniplate Removal Post-Open Reduction Internal Fixation: A Retrospective Analysis

“…Removal of miniplates has been a controversial topic since its introduction and hasn't ceased to be so. The authors who favor miniplate retention argue the potential risk caused by a second surgery under general anesthesia and profess asymptomatic removal of miniplates as uncalled for and pose more harm than favor (Khandelwal et al, 2019). This argument has been strengthened by the use of biocompatible and osseointegrative mini plates made up of titanium (Park et al, 2016).…”