J Korean Assoc Oral Maxillofac Surg.  2014 Dec;40(6):266-271. 10.5125/jkaoms.2014.40.6.266.

Reconstruction plates used in the surgery for mandibular discontinuity defect

• Seol GJ
• Jeon EG
• Lee JS
• Choi SY
• Kim JW
• Kwon TG
• Paeng JY

• KMID: 1799559
• DOI: http://doi.org/10.5125/jkaoms.2014.40.6.266

Abstract

OBJECTIVES
The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects.
MATERIALS AND METHODS
We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT).
RESULTS
Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages (9.25+/-5.10 months), plate fracture was the most common complication, but in the later stages (35.75+/-17.00 months), screw loosening was the most common complication.
CONCLUSION
It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

Keyword

Mandibular reconstruciton; Complications; Survival rates

MeSH Terms

Humans
Survival Rate
Transplants

Figure

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  Fig. 1 Plate-related complications: plate exposure, plate fracture, and screw loosening.

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  Fig. 2 A. No significant difference was found for the reconstruction plate survival rate between males and females. B. No significant difference was found for the reconstruction plate survival rate between patients that did or did not receive a bone graft.

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  Fig. 3 A significant difference was found between patients who received a coronoidectomy and those that did not.

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  Fig. 4 In two similar cases, reconstruction plate fracture did not occur in the patient who underwent coronoidectomy, while plate fracture occurred in the patient who did not undergo coronoidectomy.

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  Fig. 5 The overall survival rate, the survival curve over the first 10 months and after 35 months. A similar trend was apparent for the hazard rate, the risk of complications was low from the 10 to 35 months. Red box: high risk of plate fracture. Blue box: high risk of screw loosening.

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  Fig. 6 Schematic images representing cases in which complications developed. A defect of the mandibular angle present in almost all cases.

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  Fig. 7 Survival curves showing the decreased survival rate of reconstruction plates following postoperative radiation therapy (RT).

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