Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis

Maxillofacial fractures are a prevalent occurrence, and the widespread use of miniplates to stabilize and secure these fractures during surgery is common. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others...

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Main Authors: Mohamed Jaber, Nadin Abouseif, Noor Ibrahim, Mawada Hassan, Alaa Mohamed El-Ameen
Format: Article
Language:English
Published: MDPI AG 2023-10-01
Series:Applied Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3417/13/21/11899
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author Mohamed Jaber
Nadin Abouseif
Noor Ibrahim
Mawada Hassan
Alaa Mohamed El-Ameen
author_facet Mohamed Jaber
Nadin Abouseif
Noor Ibrahim
Mawada Hassan
Alaa Mohamed El-Ameen
author_sort Mohamed Jaber
collection DOAJ
description Maxillofacial fractures are a prevalent occurrence, and the widespread use of miniplates to stabilize and secure these fractures during surgery is common. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others suggest leaving them in place. This study aims to perform an extensive meta-analysis of pertinent studies to ascertain the destiny of miniplates employed in maxillofacial surgery and discuss the consequences of either their extraction or retention. To execute this meta-analysis, a search was conducted across number of databases, including PubMed, Google Scholar, ResearchGate, Embase, and Scopus. Keywords such as “titanium miniplates”, “screws”, “maxillofacial surgery”, “complications”, and “removal” were utilized to identify pertinent studies. The search was constrained to studies published between 1989 and 2022. The analysis encompassed only studies reporting outcomes related to miniplates in maxillofacial surgery, including complication rates and removal frequencies. Eleven studies conformed to the inclusion criteria and were incorporated into the meta-analysis, encompassing a total of 2240 patients, ten of which were retrospectives and one prospective, with the largest study involving 434 patients. The overall complication rate was determined to be 13.3%. The most prevalent reasons for miniplate removal included patient preference, tooth extraction, and infections. The average time span for miniplate removal was 10.7 months, with the most prolonged reported duration being 24 years. These findings imply that immediate removal might not be imperative in the majority of instances. In conclusion, our meta-analysis underscores the necessity of removing miniplates in cases where hardware leads to a variety of complications and physical discomfort. Principal factors driving plate removal included patient requests, tooth extractions, and infections. Ordinarily, plate removal took place within the span of 6 to 12 months, with the mandible being the most frequent site for removal. These findings accentuate the significance of extended monitoring to assess the trajectory of miniplates in maxillofacial surgery and provide valuable insights for future clinical decisions. To validate these conclusions and gain deeper insights into the factors influencing plate removal in maxillofacial surgery, further research with larger participant cohorts and standardized outcome reporting is imperative.
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spelling doaj.art-8250159303ef4393878333cf3ee7c2022023-11-10T14:59:06ZengMDPI AGApplied Sciences2076-34172023-10-0113211189910.3390/app132111899Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-AnalysisMohamed Jaber0Nadin Abouseif1Noor Ibrahim2Mawada Hassan3Alaa Mohamed El-Ameen4Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab EmiratesDepartment of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab EmiratesDepartment of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab EmiratesDepartment of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab EmiratesCollege of Science, UAE University, Al Ain P.O. Box 15551, United Arab EmiratesMaxillofacial fractures are a prevalent occurrence, and the widespread use of miniplates to stabilize and secure these fractures during surgery is common. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others suggest leaving them in place. This study aims to perform an extensive meta-analysis of pertinent studies to ascertain the destiny of miniplates employed in maxillofacial surgery and discuss the consequences of either their extraction or retention. To execute this meta-analysis, a search was conducted across number of databases, including PubMed, Google Scholar, ResearchGate, Embase, and Scopus. Keywords such as “titanium miniplates”, “screws”, “maxillofacial surgery”, “complications”, and “removal” were utilized to identify pertinent studies. The search was constrained to studies published between 1989 and 2022. The analysis encompassed only studies reporting outcomes related to miniplates in maxillofacial surgery, including complication rates and removal frequencies. Eleven studies conformed to the inclusion criteria and were incorporated into the meta-analysis, encompassing a total of 2240 patients, ten of which were retrospectives and one prospective, with the largest study involving 434 patients. The overall complication rate was determined to be 13.3%. The most prevalent reasons for miniplate removal included patient preference, tooth extraction, and infections. The average time span for miniplate removal was 10.7 months, with the most prolonged reported duration being 24 years. These findings imply that immediate removal might not be imperative in the majority of instances. In conclusion, our meta-analysis underscores the necessity of removing miniplates in cases where hardware leads to a variety of complications and physical discomfort. Principal factors driving plate removal included patient requests, tooth extractions, and infections. Ordinarily, plate removal took place within the span of 6 to 12 months, with the mandible being the most frequent site for removal. These findings accentuate the significance of extended monitoring to assess the trajectory of miniplates in maxillofacial surgery and provide valuable insights for future clinical decisions. To validate these conclusions and gain deeper insights into the factors influencing plate removal in maxillofacial surgery, further research with larger participant cohorts and standardized outcome reporting is imperative.https://www.mdpi.com/2076-3417/13/21/11899traumamaxillofacialtitaniumminiplatesmeta-analysis
spellingShingle Mohamed Jaber
Nadin Abouseif
Noor Ibrahim
Mawada Hassan
Alaa Mohamed El-Ameen
Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
Applied Sciences
trauma
maxillofacial
titanium
miniplates
meta-analysis
title Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
title_full Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
title_fullStr Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
title_full_unstemmed Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
title_short Reasons for Removal of Miniplates Used in Fixation of Maxillofacial Bone Fractures: Systematic Review and Meta-Analysis
title_sort reasons for removal of miniplates used in fixation of maxillofacial bone fractures systematic review and meta analysis
topic trauma
maxillofacial
titanium
miniplates
meta-analysis
url https://www.mdpi.com/2076-3417/13/21/11899
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