title: Removal of osteosynthesis material because of symptoms after Le Fort I osteotomy: A retrospective study of 158 patients.
abstract: The aim of this study was to analyse the incidence of removal of MESH plates because of symptoms after Le Fort I osteotomy (LF1). The medical files of patients treated with LF1 were retrospectively reviewed. The occurrence of MESH plate removal, indication for removal and time between insertion and removal were noted. The medical literature was reviewed to quantify the reported incidences of removal of titanium osteosynthesis material after LF1. A total of 158 patients were included in this study. LF1 was performed and fixed with MESH plates in 150 patients. Alternative fixation with Champy plates was used in eight patients. Three patients (2.0%) required removal of MESH plates. Seven out of 600 plates (1.2%) were removed. Reasons for removal were tenderness/pain (1), recurrent intraoral infections (1) and a nasal septum deviation correction following the LF1 (1). No statistically significant association was found with the patients' sex or age. In the literature, the reported rates of removal of titanium Champy plates range from 1.5% to 9.5% per site. This study reports a low incidence of symptomatic removal of MESH plates after Le Fort I osteotomy of 1.2% per site, which indicates an important benefit of fixation with MESH plates.
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J.P.R. van Merkesteyn), Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
authors.forename: Jop P
authors.initials: JP
authors.lastname: Verweij
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J.P.R. van Merkesteyn), Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
authors.forename: Gert J M
authors.initials: GJ
authors.lastname: Hassing
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
authors.forename: Marta
authors.initials: M
authors.lastname: Fiocco
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J.P.R. van Merkesteyn), Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
authors.forename: Pascal N W J
authors.initials: PN
authors.lastname: Houppermans
authors.affiliation: Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. J.P.R. van Merkesteyn), Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. Electronic address: J.P.R.van_Merkesteyn@lumc.nl.
authors.forename: J P Richard
authors.initials: JP
authors.lastname: van Merkesteyn
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D019340:Osteotomy, Le Fort / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult
keywords: Hardware removal; Le Fort; Orthognathic surgery; Plate removal; mesh