Risk factors contributing to symptomatic plate removal in orthognathic surgery patients.

PURPOSE: This study analyzed the fate of miniplates in orthognathic surgery and defined risk factors that eventually result in plate removal.

PATIENTS AND METHODS: The outpatient clinic files of 70 patients who had undergone orthognathic surgery were reviewed. All osteotomies were rigidly fixed with stainless steel or titanium miniplates. Study variables included age, gender, plate material, site of plates, and reasons for plate removal.

RESULTS: Of 260 plates used for fixation, 31 were removed (12%). When all factors were considered together, only age was statistically significant. Patients older than 30 years of age were more likely to have plate removal (22% vs. 9%). Only when each factor was considered separately were gender and plate material statistically significant. Females (15.4% vs. 6.7%) and stainless steel plates (15.5% vs. 6.7%) were more prone to plate removal. Although more plates were removed from the buttress (15.5%) and chin (14.5%) compared with the piriform area (6.4%), this was not statistically significant.

CONCLUSIONS: Age can be defined as a primary risk factor for plate removal, whereas gender and plate material are secondary. Although age and gender are not controllable, the use of titanium plates and infection control may lower the number of symptomatic plates and the need for their removal.