Dynamic study about metal release from titanium miniplates in maxillofacial surgery.

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Materials Engineering

Background:

• Titanium (Ti) is widely used in surgery due to its mechanical strength and corrosion resistance.
• Concerns persist regarding metal release from Ti implants and the necessity of plate removal post-healing.

Purpose of the Study:

• To investigate the relationship between the duration of Ti miniplate placement and metal release in maxillofacial surgery.
• To assess titanium levels in surrounding soft tissues after plate removal.

Main Methods:

• Prospective cohort study involving 51 patients undergoing Ti miniplate removal.
• Measurement of total and soluble Ti concentrations in soft tissues using Inductively Coupled Plasma-Optical Emission Spectrometry.
• Statistical analysis including correlation coefficients and two-way ANOVA.

Main Results:

• Average total Ti: 1306 µg/g dry tissue; average soluble Ti: 0.53 µg/g dry tissue.
• No significant correlation found between plating duration and total or soluble Ti levels (P > 0.1).
• Mechanical constraints during surgery were the primary factor influencing Ti release, with most release occurring during osteosynthesis.

Conclusions:

• Titanium miniplates appear clinically inert in the long term, with levels stabilizing post-osteosynthesis.
• Routine removal of Ti miniplates is not recommended due to the lack of correlation with plating duration and the risks of a second surgery.
• Plate removal should be considered only for specific patient complaints like infection or hypersensitivity.