Questions regarding plates and screws

[balor124]

I'm curious about options for plates and screws used in MMA surgery and have a few questions about it.

1. Has anyone here used resorbable plates and screws? What was your experience with them? Any idea what the Inion plates aren't indicated for mandible while they are indicated to be as strong as titanium?

2. Did you opt for a 2nd surgery to remove your plates and screws? What was the recovery like?

3. Those that kept them (most of you, I imagine), have the plates and screws bothered you otherwise? How isolated are reports of problems with them?

[Hostet25]

I didn't have an option with Kaiser. They use titanium screws and plates (I wont set alarms off at the airport) and they don't want to remove them if they don't have to. My surgeon said I will not feel them I guess unless I press pretty hard on my skin to feel them. He said no one will see them and they will just hang out there forever. They are really small and I have them by my nostrils and half moon shaped plates and screws by the middle of my cheeks. Also...Im only 3 1/2 weeks post op and still have my stitches along my cheeks and upper lip and they aren't that fun...plus swelling and irritation...you won't want that! I promise!

[sirwired]

Haven't really heard anything about the absorbable ones, but I'm not surprised they exist; they do for other body parts.

Speaking on a general basis, surgeons in the US generally leave the plates and screws in, as long as they aren't causing any trouble. (Sometimes the screws start to back out eventually, and in that case they are removed.) I've heard surgeons in Europe generally schedule a short operation a year or so later to remove them. (Not nearly as traumatic as putting them in! I imagine it's no more than a couple shots of anesthetic and a request to not eat anything really sharp for a few days...)

[balor124]

They use resorbable fixation for pediatric orthognathic surgery as well, just not for adults. It looks like the main reason is that they're not perceived to be strong enough. The manufacturers all say that they're not indicated for the mandible alone. I don't know why they don't use them for upper jaw surgery but I would guess it's just for simplicity and experience. They could save a few on the mandible that way still but I guess going with the tried and true method is most important.

What are the risks with the follow up surgery? What you've described doesn't sound terrible at all. Is there typically nerve loss like with the jaw surgery?

[sirwired]

The jaw surgery nerve impairment comes with the fact that the nerve trunks hug the bone that's being manipulated, but I'm pretty sure the plates and screws are not put right underneath the nerve; that'd be a silly place to put them. I would think the risks would be pretty minimal; no more risky than a gum graft, for instance.

[balor124]

I'm told I may need a gum graft in two spots anyway. I'm pretty sure it's from braces 20 years ago but it hasn't been a problem yet. Maybe I could schedule them together then. My poor mouth is gonna have a rough few years