Long-Term Complications in Patient-Specific Plates for Maxillary Reconstruction

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery
• Biomaterials Engineering

Background:

• Virtual surgical planning (VSP) enhances maxillary defect reconstruction using fibula free flaps.
• Long-term complication data for patient-specific plates (PSPs) in this context are limited.

Purpose of the Study:

• To evaluate the incidence and nature of long-term complications associated with PSPs in fibula free flap reconstructions of maxillary defects.

Main Methods:

• Retrospective review of 39 patients undergoing maxillary reconstruction with fibula free flaps and PSPs (January 2010 - July 2022).
• Primary outcomes included plate exposure, fracture, removal, or loose screws; secondary outcomes were infection, nonunion, or flap failure.

Main Results:

• 14 (35.8%) patients experienced plate-related complications, including plate removal (25.6%) and hardware exposure (30.8%).
• No plate fractures occurred. No significant differences in complications were found based on patient demographics, comorbidities, or treatment factors.
• Average time to plate removal was 2.76 years.

Conclusions:

• VSP facilitates stable maxillary reconstruction with fibula free flaps and PSPs in most patients.
• Long-term follow-up indicates up to 25% of patients may require plate removal, though reconstruction stability is generally maintained.