Posted on 6/15/2024 by Treasure Valley Oral & Facial Surgery
In rigid fixation surgeries, screws are used in conjunction with special plates to secure the jaw bones into desirable positions. These screws are not removed since they integrate into the bone structure over time.
Should Screws Be Removed After Jaw Surgery?
According to the Journal of Oral and Maxillofacial Surgery, the standard procedure for most orthognathic surgeries in the United States today involves titanium plates and screws. This hardware is designed to remain integrated into the jawbone due to the special qualities of the material and its intended use.
However, the possibility and potential for removal of this hardware should always be mentioned to patients before the operation. The incidences of titanium hardware removal after orthognathic surgery range between 0.4% and 27%, indicating a preference for these devices to remain in the jawbone. There are two main reasons for this preference.
Titanium Is Biocompatible
Orthognathic surgeons prefer titanium because it is a relatively soft, biocompatible material. Biocompatibility means that titanium does not react with the jawbone after surgery. Over time, the jawbone grows around the implant, creating a perfect bond as it heals, a process known as osseointegration. With most other metal implants, a fibrous separation layer forms, preventing perfect bonding.
Titanium Is Very Durable
Titanium implants offer value for money in jaw surgery due to their durability. Titanium implants can last for years without fractures. The main downside of using titanium is that screws and plates are visible through the skin, unlike ceramic implants, which are white and less noticeable.
When Are Screws Removed?
There are clinical situations when it becomes necessary to remove screws after jaw surgery. If a patient develops an allergic reaction to the bone, then the screws must be removed. This can be a painful and costly process that weakens the jaws and increases the risk of infection. Screws are also removed in cases where implant fractures or when they protrude through the gums, exposing the gums and jawbones to infection. In many cases, the removal of screws is not necessary and only becomes imperative when health risks are present.
In rigid fixation surgeries, screws are used in conjunction with special plates to secure the jaw bones into desirable positions. These screws are not removed since they integrate into the bone structure over time.