Maxillofacial fractures are a prevalent occurrence, and the widespread use of miniplates to stabilize and secure these fractures during surgery is common. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others suggest leaving them in place. This study aims to perform an extensive meta-analysis of pertinent studies to ascertain the destiny of miniplates employed in maxillofacial surgery and discuss the consequences of either their extraction or retention. To execute this meta-analysis, an exhaustive search was conducted across multiple databases, encompassing PubMed, Scopus, and Google Scholar. Keywords such as "titanium miniplates," "screws," "maxillofacial surgery," "complications," and "removal" were utilized to identify pertinent studies. The search was constrained to studies published between 1989 and 2022. The analysis encompassed only studies reporting outcomes related to miniplates in maxillofacial surgery, including complication rates and removal frequencies. Eleven studies conformed to the inclusion criteria and were incorporated into the meta-analysis, encompassing a total of 2240 patients. All the studies had a retrospective design, with the largest study involving 800 patients. The overall complication rate was determined to be 13.3%. The most prevalent reasons for miniplate removal included patient preference, tooth extraction, and infections. The average time span for miniplate removal was 10.7 months, with the most prolonged reported duration being 24 years. These findings imply that immediate removal might not be imperative in the majority of instances. In conclusion, our meta-analysis underscores the necessity of removing miniplates in cases where hardware leads to a variety of complications and physical discomfort. Principal factors driving plate removal included patient requests, tooth extractions, and infections. Ordinarily, plate removal took place within the span of 6 to 12 months, with the mandible being the most frequent site for removal. These findings accentuate the significance of extended monitoring to assess the trajectory of miniplates in maxillofacial surgery and provide valuable insights for future clinical decisions. To validate these conclusions and gain deeper insights into the factors influencing plate removal in maxillofacial surgery, further research with larger participant cohorts and standardized outcome reporting is imperative.

The use of miniplates for stabilizing bones after orthognathic surgeries, has become increasingly popular for their effectiveness in ensuring stability and promoting swift recovery. However, the post-surgical fate of these miniplates remains a subject of contention among surgeons. Some advocate for their removal, while others suggest leaving them in place. The aims of this study, is to evaluate the incidence, causes, and potential risk factors associated with the removal of miniplates in orthognathic surgeries. A comprehensive meta-analysis was conducted by reviewing studies from various databases like PubMed, Google Scholar, Research Gate, Embase, and Scopus, focusing on publications from 1989 to 2023. Ten studies encompassing a total of 1603 patients which conformed to the inclusion criteria were selected and included in the meta-analysis. With M:F ratio range from 4:1 to 109:141. Total number of miniplates inserted was 5595, and total number of miniplates removed were 294 (5.3%). The most common reasons for miniplates removal were, infection was reported in 161 cases (2.9%), followed by miniplates exposure (34 cases, 0.6%) and palpable plates (23 cases 0.4%). Other indications included pain, patient’s preference, and temperature sensitivity. Relatively less common reasons that resulted in miniplates removal include, sinusitis, second surgery and dental pathology. The mean duration of miniplates removal was 5.5 months with the majority of miniplates (56.1%) were removed from the mandible compared to maxilla. In conclusion, this meta-analysis underscores the importance of miniplate removal in cases where hardware causes diverse complications and physical discomfort. The primary reasons for miniplates removal were infections and plates exposure, with the mandible being the most common site for removal. These findings emphasize the need for continued monitoring to assess the fate of miniplates in orthognathic surgery and provide valuable insights for future clinical decision-making.