Reasons for Removal of Mandibular Reconstruction Plates

Background: Mandibular reconstruction plates (MRPs), used alone or alongside bone reconstruction, are now the standard approach for treating mandibular continuity defects. Advancements in plate design and materials have improved the success rate of mandibular reconstruction. Nonetheless, plate-related complications remain prevalent and may, in some cases, result in significant morbidity for patients. Objective: To determine complications associated with MRPs and analyse parameters related to the complications. Methods: A descriptive cross-sectional retrospective study was undertaken over a 5-year period (from January 2018 to December 2022) on patients who had complications after segmental resection and reconstruction with MRPs. Complications were analysed according to age, sex, location of defect, defect size, and whether the patient underwent a bone graft procedure or not. Univariate binary logistic regression was used to determine the predictors of complications. The level of significance was set at P ≤0.05. Results: A total of 100 patients were enrolled in the study. Benign and malignant tumors accounted for 76 and 18 cases, respectively. The prebent technique was used in 96 patients. LCL (63%), LC (18%), and HCL (14%) were the most observed defects. Dehiscence (n = 38), infection (n = 21), and plate fracture (n = 9) were the most common complications. Smoking ( P = 0.005) and smoking and alcohol ( P = 0.008) were significantly associated with the presence of infection. Six of the 9 patients with plate fracture had no bone graft. Plate length was significantly higher in participants with plate failure ( P = 0.032). Conclusions: Risk stratification for plate-related complications should consider factors such as plate length, defect type, soft tissue adequacy, and smoking and tobacco use. Patients with anterolateral defects and longer reconstruction plates are at higher risk for complications.