IS IT NECESSARY TO REMOVE OSTEOSYNTHETIC MATERIAL AFTER FACIAL BONE OSTEOSYNTHESIS - RESULTS OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS

We discuss the arguments dealing with removal of fixation devices and plates after osteosynthesis of facial bone fractures. As an experiment al model for examining the soft tissue reaction to implants under stan dard conditions, an inguinal flap was prepared in 24 Wistar rats. Tita nium mesh implants (10X8X0.3 mm) were then inserted into the flaps. Tw elve implants were additionally bent to investigate histologically the influence of mechanical preparation on tissue reactions. Examination of all specimens was carried out with the technique of Donath and show ed a thin capsule around the titanium implants but without any signs o f infection. Around the bent areas of the implants there were minimal signs of local chronic inflammation without a capsule. Use of titanium microplates instead of miniplates in 89 patients with midfacial fract ures diminished the rate of local complications. Based on our experime ntal and clinical results, indications for the different types of plat es and the necessity for their later removal are discussed. Our presen t plates are only removed from the maxillary sinus wall and the alveol ar ridge, after osteosynthesis in children, and in patients with local complications. If removal of the material is planned (because of the location), less expensive steel implants are used.