Frequency and Reasons for Fixation Hardware Removal After Orthognathic Surgery in Patients Treated in One Center

Background and Objectives: Despite the well-established position of orthognathic surgery as a field of surgical treatment of deformities within the facial skeleton, it has not been possible to develop unanimous recommendations on how to approach fixation hardware after the healing period. In the absence of clear guidelines from opinion leaders and scientific societies on how to approach osteosynthesis after surgery, the decision to leave or remove fixation hardware is made individually by treatment centers, mostly based on their own experience. It is also important whether or not surgical procedures are financed by public funds. This issue extends beyond orthognathic surgery, affecting all facial skeleton procedures involving osteosynthesis materials. The aim of this study is to analyze the frequency and reasons for fixation hardware removal after orthognathic surgery in patients treated in one center. Materials and Methods: This retrospective study examined the medical records from 2015 to 2020 of patients treated surgically for skeletal deformities at the Department and Clinic of Otolaryngology and Maxillofacial Surgery of Collegium Medicum (formerly the Otolaryngology Department of the Provincial Hospital in Zielona Góra). This study analyzed the age and sex of patients, the type of orthognathic procedure, and the type of skeletal deformity, as well as the reasons for fixation hardware removal in the groups of patients. Results: During this period, 124 orthognathic procedures were performed, including 56 one-jaw operations (BSSO or Le Fort I maxillary osteotomy), 2 one-jaw operations with genioplasty, 55 bimaxillary operations (BSSO + Le Fort I maxillary osteotomy), 6 bimaxillary surgery with genioplasty and 5 isolated genioplasty procedures. Fixation hardware was removed in 77 cases (62.10% of procedures), comprising 57 women and 20 men. Reasons for osteosynthesis removal were divided into three groups: complications such as the occurrence of inflammatory reaction/infection (n = 17), subjective discomfort (n = 23), and patient requests (n = 37). Conclusions: The findings underscore the need for scientific societies to establish unified guidelines on managing post-surgical fixation hardware to standardize care and enhance patient outcomes.