The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous
genioplasty, and
intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental
dentofacial deformity (
DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I
osteotomy, bilateral sagittal ramus
osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous
genioplasty. The primary outcome variable studied was fixation hardware removal. Demographic, anatomical, and surgical predictor variables were assessed. Two hundred sixty-two subjects met the inclusion criteria. Their mean age at operation was 25 years (range 13-63 years); 134 were female (51.1%). Simultaneous removal of a third molar was performed in 39.9% of SROs. Three of 262 Le Fort I procedures (1.1%) and two of 524 SROs (0.4%) required hardware removal. There were four cases of ramus
wound dehiscence, four of ramus
surgical site infection (SSI), one of chin SSI, two of
maxillary sinusitis, and one of
lingual nerve injury; none of these subjects underwent hardware removal. A limited need for fixation hardware removal after orthognathic procedures was confirmed. There was no statistical correlation between hardware removal and patient sex, age, pattern of
DFD, simultaneous removal of a third molar, or occurrence of
wound dehiscence, SSI, or
lingual nerve injury.