No need to routinely remove titanium implants for maxillofacial fractures

Publication date: Available online 7 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Yongchun Yu, Weilong Liu, Jinlong Chen, Li Quan, Xiaohui Zheng, Lei Liu

Abstract

Purpose

Titanium implants are typically used to fix maxillofacial fractures and routine removal of them is a controversial topic in maxillofacial surgery. The study aims were to estimate the removal rate and risk factors associated with the removal.

Materials and Methods

The investigators designed and implemented a retrospective study. Adult patients who had open reduction and internal fixation with titanium implants for maxillofacial fractures were included and those who returned to theatre for implant removal were identified from January 2007 to December 2016. The predictor variables were sex, age, preoperative infection, injury time, trauma cause and fracture site. The primary outcome variable was the removal of titanium implants. Descriptive and bivariate statistics were computed. Kaplan-Meier survival methods were used to estimate rate of removal. Univariate and multivariate cox proportional hazards model were used to identify risk factors associated with the removal.

Results

Among the 2325 patients including 1890 males and 435 female, with an average age of approximately 35.49 years registered in this study, 163 (7.01%) patients had their titanium implants removed and one-,two- and ten-year removal rate were 3, 7, and 8% respectively. The risk factors most closely associated with the removal were preoperative infection, injury by blow from object, obsolete fracture and being female.

Conclusions

Routinely removing titanium implants in maxillofacial fracture patients is not necessary. When the risk factors mentioned above are present in maxillofacial fracture patients, follow-up should be scheduled more frequently.

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