Plates Removal in Orthognathic Surgery and Facial Fractures: When and Why

Background: There is agreement that symptomatic plates should be removed, but there is no consensus among maxillofacial surgeons on the need for routine removal of asymptomatic plates. Only by evaluating long follow-up studies conducted with large-volume data that guidelines about when to remove and why remove plates used for internal rigid fixation can be traced. Materials and Methods: This study was conducted as a retrospective study. Clinical findings of all the patients presented at the department of maxillofacial surgery of 2 Italian hospitals, in whom miniplates were inserted between January 2004 and December 2007, were included: a follow-up of these patients was conducted until August 2009. Results: The region most involved with plates' insertion was the upper maxilla (49.8%), followed by mandibular body (38.1%), angle (7.9%), condyle (2.4%), and symphysis (1.8%). The region most involved in plates' removal was the maxilla in 9%, followed by mandibular body in the 7.5%. All plates inserted in angle regions were removed. Plates placed in the condylar area did not need any plate removal. Conclusions: From this study, there is no evidence to support the advice for routine removal of titanium miniplates from the maxillofacial skeleton, although when using plates in the mandibular angle region, it would be necessary to inform the patient about the very high probability of a second operation necessary for the plates' removal.