Corrective jaw surgeryis a procedure whereby the jaw bone is cut, detached, moved to a different position and held there with some sort of fixation device. In the past, the fixation device comprised mainly stainless steel wires to tie the jaws in the new position. Today, this is achieved by using plates and screws placed internally to provide a rigid fixation. Some patients are concern about the possibility of setting off metal detectors at the airport while others wonder whether having the metal plates and screws in their body affects their health in the long run. Can these fixation plates and screws be removed? Should they be removed?
Purpose of fixation plates
The purpose of having fixation plates is to keep the cut repositioned jaws in the newly planned position so that the bones can heal. Corrective jaw surgery is basically a surgically performed fracture. To allow the fractured bone to heal, the two ends need to be placed in contact with minimal movement for the first six weeks. When someone breaks a leg and a plaster of Paris cast is placed over the leg, the cast is basically immobilizing the to broken ends so that the fracture can heal. In corrective jaw surgery, the plates and screws serves that function of immobilizing the two fragments relative to each other.
What are they made of?
These fixation plates and screws are made of titanium. Titanium is a fairly soft metal that has the unique property of not eliciting a foreign body reaction from the bone. In fact the bone cells actually attach themselves onto titanium directly, without an intervening fibrous layer that is present in other metallic implants. The plates can be pre-fabricated in the factory or they can patient-specific custom-made by 3D printing.
Should they be removed?
Because the titanium is seamlessly integrated with bone, these fixation plates need not be removed. They also do not set off alarms at airports or other metal detectors. However, sometimes, they may become exposed through the gums due to thin gums or superficial placement of the plates during surgery. When exposed, the plates are susceptible to infection and should be removed. Otherwise, they can be left alone.
Can they be removed?
As most orthognathic patients are young, some parents are concern about the any unknown risks that may surface many years later and request for their removal. These plates can be removed once the bone has healed as they do not serve any purpose after that. The best time to remove these plates is about one year after orthognathic surgery. At that point, the healing is completed and the bone has remodeled and the surgical results would have reach stability. However beyond a year, removal progressively becomes difficult due to the integration of the bone with the implants and screws. Late removal of the plates often requires a fair bit of bone removal to expose the plates. Screws may not be retrievable at all without extensive drilling of the bone.
In general, fixation plates that do not become exposed do no require removal after orthognathic surgery. However, if removal is desired by the patient, it should be done after about one year. Late removal is usually not recommended due to increase morbidity without any benefit.
I have had a mandible fracture in 2013. I can now feel my plate through my gums and it is beginning to hurt. I'm not sure what could be causing the pain and am not sure what to do. Could you recommend some suggestions. Please and thank you!
Call your oral surgeon, they will check it out. I'm having to go back in after an issue from a surgery 2005, so they will always follow up with you if there are issues.
tuesdsy, do you mind sharing what your issue is. i had my surgery in 2002 and i'm having major gastric issues
I had my surgery in 2001 and started having severe gastric issues in 2003 and have suffered ever since! I never related the two until now! I watched the Bleeding edge on Netflix and realized that after surgery was when I seemed to have a whole bunch of ihealth issues
My boyfriend has a previous jaw injury where it requires plates and now he has a small hole in the back of his mouth from where he said the wire cut him. And it’s been like that for about two years. How urgent should he see somebody? And does smoking with something like a hole in the back of his mouth increase his risk for oral cancer ?
Jaw surgery happened for me where they moved both jaws in teh late 90's why do i feel something moving around in jaw now in 2018?
antonio, do you have any problems with your implants, now. do you have gastric issues(stomach/liver/pancreas). I reaching out because i have had screws and plates and i've had nothing but gastric problems for the last 8 years. all of my doctors are say the same this is this page, you don't have to remove them. i thinks that's crap. i've have constant ringing in my ears for years because of this metal in my face.
I had jaw surgery in 1997. While I don’t feel something moving around like you do I am curious if titanium was used at the time or stainless steel. My jaw surgery was done at a military hospital so I don’t have a lot of information on it. I am currently dealing with autonomic dysfunction, neuropathy and possibly a connective tissue disorder and I am wondering if my jaw surgery plays any part of how I am feeling.
Your blog was more informative. It has given a lot of information about Jaw surgery.And more informative about the process of the Jaw Surgery
I have lower jaw surgery 11/10/2022 his fixed 2mm plate [1nos] 2mm screws (4nos) 3rd molar tooth on the left was extracted. my question is when I was remove the plate? the plate removing is Nessasery? please give a response thank you
Had jaw surgery and titanium put in my jaw back in 1990, I have a screw and part of the plate coming through my gum..Having surgery in March to remove. I am worried that it will be a more endepth surgery then what the Dr. Said. All so not able to go to the surgeon who did the original surgery. That's another issue I am having. Any suggestions will help.
Dear Tammy, if the screw and plate are already exposed, removal is generally not too difficult. But do discuss your concern with your surgeon.
Alot of problems from jaw surgery
I have lower jaw sergury with 2 titanium plate and 8 screws but i want to remove that anyone's tell me healing process and how much time any risk for them please
Hi I had my top jaw moved about 30 years ago. The only problem with plates was about 10-15 years ago when the plate on left hand side of gum started to come through and I had it removed surgically. Move forward to now and it appears the other plate from the right hand side of gum has moved but into my right nostril and causing so many issues with my sinuses. Has anyone ever heard of plates moving around/in to nostril? Thanks
Omg could this be why I have a chronic runny nose? I never considered it could be part of my jaw surgery. I had a 1999. I had a Laforte one ostomy and bilateral sagittal split. I have six metal plates and 26 screws throughout both upper and lower jaws. It was an almost 7 hour long surgery. I have never even heard of getting screws and plates removed until an oral surgeon asked me about it two weeks ago when I went in to have a dental implant and had oral surgery. Now I’m looking into the information out of curiosity.