Plate Exposure after Mandibular Resection with Plate Reconstruction: Contributing Factors

Background Mandibular resection is one of treatment in pathological lesions that involve the mandibular bone. This procedure normaly followed by the placement of plate reconstruction that often causes a facial deformity. Plate exposure is one of the complications during post-operative period and may require removal of the expose hardware or even multiple debridements. Objective This article aiming to detect risk factors for plate exposure after fixation of reconstruction plate following mandibular resection. Methods We performed a retrospective analysis of 72 cases of mandibular reconstruction with reconstruction plates following mandibular resection in 2016 to 2018 in Oral and Maxillofacial Department of Hasan Sadikin Hospital Bandung. Various factors such as sex, age, type of resection, diagnosis, history of systemic disease, postoperative radiation or chemotherapy and number of leukocytes were analyzed as significant risk factors for plate exposure Findings. From 2016 to 2018, 72 patients underwent mandibular resection and all of them had fixation of reconstruction plate. The mean age of the study group was 38, with a predominance of female patients (65.5 %). Patients with malignancy and post-operative radiation therapy and chemotherapy were more likely to have plate exposure. Plate exposure was found in 14 cases (21.8 %). From 14 cases of the plate exposure, 4 cases (28.6 %) underwent plate removal, 8 cases (57.1 %) underwent reconstruction with flap, and 2 cases (14, 3 %) died. Conclusion Diagnosis of malignancy and post-operative radiation therapy and chemotherapy are associated with higher rates of plate exposure. The management of plate exposure may require multiple procedures such as free flap or local flap reconstruction.