Rauso Raffaele, Tartaro Gianpaolo, Stea Stefano, Tozzi Umberto, Biondi Paolo
II University of Naples, Villa Cecilia Hospital, Cotignola, RA, Italy.
J Craniofac Surg. 2011 Jan;22(1):252-4. doi: 10.1097/SCS.0b013e3181f7b7f4.
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.
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.
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.
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.
对于有症状的接骨板应予以取出已达成共识，但颌面外科医生对于是否需要常规取出无症状接骨板尚未达成一致意见。只有通过评估大量数据的长期随访研究，才能确定关于何时取出以及为何取出用于坚固内固定的接骨板的指南。
本研究为回顾性研究。纳入了2004年1月至2007年12月期间在意大利两家医院颌面外科就诊且植入微型接骨板的所有患者的临床资料，并对这些患者进行随访直至2009年8月。
接骨板植入最常见的部位是上颌骨（49.8%），其次是下颌体（38.1%）、下颌角（7.9%）、髁突（2.4%）和下颌联合（1.8%）。接骨板取出最常见的部位是上颌骨（9%），其次是下颌体（7.5%）。所有植入下颌角区域的接骨板均被取出。植入髁突区域的接骨板无需取出。
本研究表明，没有证据支持从颌面骨骼常规取出钛微型接骨板的建议，尽管在下颌角区域使用接骨板时，有必要告知患者有很高概率需要进行二次手术取出接骨板。
