From the Research
Low-profile reconstruction plates are generally preferred over high-profile plates in Oral and Maxillofacial Surgery (OMFS) due to their thinner design, which reduces the risk of plate exposure, palpability, and thermal sensitivity, leading to better patient comfort and potentially lower rates of hardware removal. The choice between low-profile and high-profile reconstruction plates depends on the specific clinical application and the need for stability. Low-profile plates, typically 1.0-1.5mm thick, are suitable for most mandibular and midface fractures, as well as orthognathic surgery, as they provide a good balance of stability and patient comfort 1.
When using low-profile plates, it is essential to:
- Use 2.0mm screws for mandibular fractures
- Use 1.5mm screws for midface fractures
- Ensure proper adaptation to bone contours
- Use locking screws when additional stability is needed
High-profile plates, being thicker (usually 2.0-2.5mm), are reserved for cases requiring maximum stability, such as:
- Dealing with severely comminuted fractures
- Reconstructing large defects
- Managing fractures in patients with osteoporosis or other bone quality issues
A study published in the Journal of cranio-maxillo-facial surgery found that the success of alloplastic reconstruction plates of the mandible is dependent on various risk factors, including defect size, localization of resection, and patient factors such as smoking 2. Another study published in the Annals of maxillofacial surgery demonstrated the effectiveness of low-profile locking mandibular reconstruction plates in the treatment of comminuted mandibular fractures, with no complications such as malocclusion, surgical site infection, or malunion reported 1.
In terms of morbidity, mortality, and quality of life, the use of low-profile reconstruction plates can lead to better patient outcomes due to reduced complications and improved patient comfort. A study published in the British journal of oral & maxillofacial surgery found that the overall complication rate for reconstruction plates was 39%, with extraoral exposure, intraoral exposure, and loose osteosynthesis screws being the most common complications 3.
Overall, the choice of reconstruction plate should be based on the individual patient's needs and the specific clinical application, with low-profile plates being generally preferred for most OMFS applications due to their thinner design and reduced risk of complications.