Ömer ÜLKER, Ahmet Emin DEMİRBAŞ, Nükhet KÜTÜK, Erdem KILIC, Alper ALKAN

ORTOGNATİK CERRAHİ SONRASI OSTEOSENTEZ TİTANYUM MİNİPLAKLARIN ÇIKARILMA NEDENLERİ VE İNSİDANSI

Bu çalışma ile ortognatik cerrahi sonrası osteosentez plağının çıkarılmasının insidansı ve nedenleri araştırıldı. Çalışmaya Erciyes Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Hastanesi'nde Nisan 2011-Şubat 2017 tarihleri arasında ortognatik cerrahi geçiren 250 hasta (141 kadın ve 109 erkek) dahil edilmiştir. Hastaların takip dosyaları, operasyon notları ve radyografik görüntüleri geriye dönük olarak incelendi. Ameliyat tarihleri, yaş, cinsiyet, maloklüzyon tipi, fiksasyon ve ortognatik cerrahi teknikleri sınıflandırıldı. Osteosentez titanyum mini plağın çıkarılma insidansı ve nedenleri, yerleştirme ile çıkarma arasındaki ortalama süre belirlendi. Hastaların ortalama yaşı 22.9 ± 6.5 [en küçük: 17; en büyük: 55]. Ondört hastada (%5.6) fiksasyona bağlı komplikasyonlar gelişti. Plak enfeksiyonu (dokuz vaka- %3.6) ve plağın açığa çıkması (beş vaka- %2,0) nedeniyle plaklar çıkarıldı. Kullanılan toplam plak sayısı 1242'dir [800 (%64)’ü maksillada ve 442 (%36)’si mandibulada]. Fiksasyon materyali ile ilgili komplikasyonlar nedeniyle maksilla [11 (%1.3)] ve mandibuladan [12 (%2.7)] yirmi üç plak çıkarıldı. Ortalama plak çıkarma süresi 11.21± 8.21ay (en düşük:3- en yüksek:34ay)’dı. Osteosentez plakları ortognatik cerrahi sonrası enfeksiyon ve plağın açığa çıkması nedeniyle çıkarılmalıdır. Komplikasyon ortaya çıkmadıkça yerinde bırakılmalıdır.

Anahtar Kelimeler:

Enfeksiyon, ortognatik cerrahi, osteosentez plaklarının çıkarılması, plağın açığa çıkması, titanyum miniplak

INCIDENCE AND CAUSES OF OSTEOSYNTHESIS TITANIUM MINIPLATE REMOVAL FOLLOWING ORTHOGNATHIC SURGERY

This paper investigated the incidenceand causes of osteosynthesis plate removal after orthognathic surgery. The sample consisted of 250 patients (141 women and 109 men) who underwent orthognathic surgery between April 2011 and February 2017 at the Oral and Maxillofacial Surgery Hospital of the Faculty of Dentistry of Erciyes University. Follow-up files, operation notes, and radiographic images were reviewed retrospectively. Operation dates, age, sex, malocclusion type, fixation methods, and orthognathic surgery methods were classified. The incidence and causes of osteosynthesis titanium miniplate removal and the average time between placement and removal were determined. Patients had a mean age of 22.9 ± 6.5 [min: 17; max: 55]. Fourteen patients (5.6%) developed fixation-related complications. They underwent plate removal due to plate-infections (nine cases- 3.6%) or plate exposure (five cases- 2.0%). The total number of plates used was 1242 [800 (64%) in the maxilla and 442 (36%) in the mandible]. Twenty-three plates were removed from the maxilla [11 (1.3%)] or mandible [12 (2.7%)] due to fixation material-related complications. The mean plate removal time was 11.21± 8.21 months (min:3- max:34 months). Osteosynthesis plates should be removed due to infections and plate exposure after orthognathic surgery. There should be left in place unless complications arise.

Keywords:

Infection, orthognathic surgery, osteosynthesis plate removal, plate exposure, titanium miniplate,

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