Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Int J Oral Maxillofac Surg. 2010 May;39(5):430-5. doi: 10.1016/j.ijom.2010.01.016. Epub 2010 Feb 23.
Removal of miniplates is a controversial topic in oral and maxillofacial surgery. Originally, miniplates were designed to be removed on completion of bone healing. The introduction of low profile titanium miniplates has led to the routine removal of miniplates becoming comparatively rare in many parts of the world. Few studies have investigated the reasons for non-routine removal of miniplates and the factors that affect osteosynthesis after osteotomy in large numbers of patients. The aim of the present study was to investigate complications related to osteosynthesis after bilateral sagittal split osteotomy (BSSO) in a large number (n=153) of patients. In addition to the rates of removal, emphasis was placed on investigating the reasons and risk factors associated with symptomatic miniplate removal. The rate of plate removal per patient was 18.6%, the corresponding rate per plate being 18.2%. Reasons for plate removal included plate-related complications in 16 patients and subjective discomfort in 13 patients. Half of the plates were removed during the first postoperative year. Smoking was the only significant predictor for plate removal. Patients undergoing orthognathic surgery should be screened with regard to smoking and encouraged and assisted to cease smoking, at least perioperatively.
小型钢板的去除在口腔颌面外科学中是一个有争议的话题。最初，小型钢板的设计目的是在骨愈合完成后将其取出。由于引入了低轮廓钛制小型钢板，在世界上许多地区，常规去除小型钢板变得相对罕见。很少有研究调查大量患者中非常规去除小型钢板的原因以及影响截骨术后骨合成的因素。本研究旨在调查 153 例大量患者双侧矢状劈开截骨术（BSSO）后与骨合成相关的并发症。除了去除率外，还强调了与有症状的小型钢板去除相关的原因和危险因素的调查。每位患者的钢板去除率为 18.6%，每个钢板的相应去除率为 18.2%。去除钢板的原因包括 16 例患者的钢板相关并发症和 13 例患者的主观不适。有一半的钢板在术后第一年被去除。吸烟是唯一显著的钢板去除预测因素。接受正颌手术的患者应进行吸烟筛查，并鼓励和协助其至少在围手术期戒烟。
