Reasons for Removal of Titanium Hardware in Postoperative Patients with Maxillofacial Trauma

Zahid  Dildar; Muhammad  Ishaq; Ali Akhtar  Khan; Shafi Ullah  Khan; Syed Junaid Hussain  Bukhari; Tariq  Mahmood

doi:10.51253/pafmj.v75i1.11416

Authors

Zahid Dildar Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Ishaq Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Ali Akhtar Khan Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Shafi Ullah Khan Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Syed Junaid Hussain Bukhari Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Tariq Mahmood Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i1.11416

Keywords:

Maxillofacial Trauma, Reasons for hardware removal, Titanium hardware

Abstract

Objective: To determine the reasons for removing titanium hardware (mini plates, microplates, and titanium screws) in postoperative patients with maxillofacial trauma.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Armed Forces Institute of Dentistry Rawalpindi, Pakistan from Mar to Dec 2023.

Methodology: A total number of Fifty-one (n=51) patients reported to the Oral Surgery Department of the Armed Forces Institute of Dentistry for hardware removal previously treated with maxillofacial trauma. After following inclusion and exclusion criteria, consecutive sampling was performed. Reasons for hardware removal were evaluated and recorded.

Results: Out of a total of fifty-one individuals, 41(80.3%) were male and 10(19.7%) were females. Of 51 patients, 18(35.2%) reported the complaint of pus discharge as their main reason for seeking expert opinion. In 24(47%) patients, elective hardware removal was performed due to the patient's demands. Meanwhile, 4(7.8%) patients reported the chief complaint of experiencing pain and unpleasant sensations. Hardware palpability was another factor reported by 5(9.8%) of the patients for hardware removal.

Conclusion: The patient's request and infections were the leading causes of the plates and screws removal. The plate removal usually took place 6 to 12 months after initial surgery, and the mandible was the most often region from where these mini plates and screws were removed.

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References

Reddy PA, PU AW, Jagadish V. Incidence of infected hardware removal in oral and maxillofacial region. J Contemp Issues Bus Gov 2021; 27(2): 2544.

https://doi.org/10.47750/cibg.2021.27.02.263

Kumar MAS, Marimuthu M, Duraisamy R. Osteosynthetic Materials Used in Open Reduction and Internal Fixation of Facial Fractures in University Hospital Setting-A Retrospective Study. Indian J Forensic Med Toxicol 2020; 14(4): 5119–5125.

https://doi.org/10.37506/ijfmt.v14i4.12432

Aramanadka C, Kamath AT, Srikanth G, Pai D, Singla N, Daundiyal S, et al. Hardware Removal in Maxillofacial Trauma: A Retrospective Study. Sci World J 2021: 9947350.

https://doi.org/10.1155/2021/9947350

Riviș M, Roi C, Roi A, Nica D, Văleanu A, Rusu LC, et al. The Implications of Titanium Alloys Applied in Maxillofacial Osteosynthesis. Appl Sci 2020; 10(9): 3203.

https://doi.org/10.3390/app10093203

Piombino P, Sani L, Sandu G, Carraturo E, De Riu G, Vaira LA, et al. Titanium Internal Fixator Removal in Maxillofacial Surgery: Is It Necessary? A Systematic Review and Meta-Analysis. J Craniofac Surg 2023; 34(1): 145–152.

https://doi.org/10.1097/SCS.0000000000009006

Halim M, Khattak YR, Khan A. Common Nerve Injuries In Oral And Maxillofacial Trauma: A Cross-Sectional Study At Khyber College Of Dentistry Peshawar. J Khyber Coll Dentisrty 2018; 8(02): 7–11.

https://doi.org/10.33279/jkcd.v8i02.424

Albert D, Muthusekhar M, Selvarasu K. Miniplate Removal Post-Open Reduction Internal Fixation: A Retrospective Analysis. J Contemp Issues Bus Gov 2021; 27(2): 2944.

https://doi.org/10.47750/cibg.2021.27.02.302

Daniels JS, Albakry I, Braimah RO, Samara MI. Is the Routine Removal of Titanium Plates and Screws Following Miniplate Osteosynthesis of Maxillofacial Bone Fractures Justified? A Fifteen-Year Experience in a Maxillofacial Centre, Saudi Arabia. Craniomaxillofacial Trauma Reconstr Open 2021; 6: 247275122110652. https://doi.org/10.1177/24727512211065268

Hernandez Rosa J, Villanueva NL, Sanati-Mehrizy P, Factor SH, Taub PJ. Review of Maxillofacial Hardware Complications and Indications for Salvage. Craniomaxillofacial Trauma Reconstr 2016; 9(2): 134–140. https://doi.org/10.1055/s-0035-1570074

Dong QN, Kanno T. Bioresorbable Bone Fixation Devices for Oral and Maxillofacial Surgery. In: Choi AH, Ben-Nissan B, editors. Innovative Bioceramics in Translational Medicine II: Surgical Applications. Singapore: Springer; 2022. https://doi.org/10.1007/978-981-16-7439-6_3

Çi̇men E, Cambazoğlu M, Önder ME. A Comparison of Titanium and Resorbable Miniplate Systems Using Finite Element Analyses with the Orthotropic Mandibular Model in Condyle Fracture. Selcuk Dent J 2021; 8(3): 713–720.

https://doi.org/10.15311/selcukdentj.780549

Tino T, Pinto Ferreira BS, Ribeiro De Oliveira AR, De-Oliveira Melo LA, CorrêaDe-Faria PA, Neves D, et al. Epidemiology of Maxillofacial Trauma in a Brazilian Emergency Hospital: A Retrospective Study. J Surg Clin Dent 2022; 26(1): 356.

http://www.mastereditora.com.br/jscd2358-0356

Jaber M, Abouseif N, Ibrahim N, Hassan M, El-Ameen AM. Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis. Appl Sci 2023; 13(21): 11899. https://doi.org/10.3390/app132111899

Sukegawa S, Masui M, Sukegawa-Takahashi Y, Nakano K, Takabatake K, Kawai H, et al. Maxillofacial Trauma Surgery Patients With Titanium Osteosynthesis Miniplates: Remove or Not? J Craniofac Surg 2020; 31(5): 1338–1342.

https://doi.org/10.1097/SCS.0000000000006352

Mushtaq M, Shah K, Khattak YR, Khan T, Ashraf N. Removal of titanium plates in post-operativepatients with maxillofacial traumaa five years retrospective study. J Khyber Coll Dentisrty 2019; 9(01): 40–43. https://doi.org/10.33279/jkcd.v9i01.336

Gorrela H. Policy towards Removal of Mini Plates in Maxillofacial Trauma –A Follow up Study of 234 Patients. J Surg Proce Case Rep 2019; 1-6. https://doi.org/10.17303/jspcr.2019.1.102

Pan Z, Patil PM. Titanium osteosynthesis hardware in maxillofacial trauma surgery: to remove or remain? A retrospective study. Eur J Trauma Emerg Surg 2014; 40(5): 587–591. https://doi.org/10.1007/s00068-013-0348-5

Capucha T, Shilo D, Abdalla-Aslan R, Blanc O, Ginini JG, Semel G, et al. Is Open Reduction Internal Fixation Using Titanium Plates in the Mandible as Successful as We Think? J Craniofac Surg 2022; 33(4): 1032–1036.

https://doi.org/10.1097/SCS.0000000000008258