Higher need for removal of osteosynthesis material after multi-piece versus one-piece Le Fort I osteotomy: A retrospective study of 339 patients

The aim of the present study was to identify the risk factors for removal of osteosynthesis material after multi-piece Le Fort I osteotomy compared to standard one-piece Le Fort I osteotomy (LF1). Medical files of patients treated with multi-piece or one-piece LF1 were retrospectively reviewed, including the indication for removal and time between insertion and removal. A total of 339 patients were included: 290 patients with LF1 and 49 patients with multi-piece LF1. Patients undergoing multi-piece LF1 had 2.7-times significantly higher (p < 0.001) relative risk of osteosynthesis removal in the upper jaw (42.9%) than patients undergoing LF1 (15.9%). Significant independent predictors of removal of osteosynthesis material after multi-piece LF1 were older age (odds ratio [OR] 1.1, 95% confidence interval [CI] 1.0-1.2; p = 0.028), simultaneous bilateral sagittal split osteotomy (OR 7.8, 95% CI 1.2-50.3; p = 0.031), and no previous surgically assisted rapid palatal expansion (OR 0.14, 95% CI 0.03-0.69; p = 0.15). Significantly higher removal rates of osteosynthesis material were found after multi-piece LF1. Therefore, all patients must be informed of the higher risk for removal of osteosynthesis material when undergoing a multi-piece LF1.