## 4 Discussion
[18] highlighted 1 case of miniplate removal due to cold intolerance, and 2 instances stemming from plate failure, out of 384 miniplates. [PERSON] et al. [16] outlined 5 cases of plate removal due to palpable plates, and 6 occurrences due to dental/nerve damage, out of 609 miniplates. Miniplate fractures can occur due to various factors, including improper plate placement, or excessive stress on the plate. [PERSON] et al. [12] detailed 4 cases of miniplate removal due to plate fracture out of 105 miniplates. Loose fixation devices represent another cause for miniplate removal in maxillofacial fracture treatment. Loose fixation devices can result from several factors, including suboptimal plate placement, improper screw positioning, or undue stress on the plate. [PERSON] et al. [15] noted 7 instances of miniplate removal, due to the loose fixation, out of 599 miniplates. Patient request constitutes another rationale for the removal of miniplates employed in maxillofacial fracture treatment. Furthermore, other reasons encompass poor aesthetics, exposure, cold intolerance, nerve impairment, and cancer phobia. Regarding the time span between initial surgery and miniplate removal, the majority of cases involved removal within one year. According to existing literature, most miniplate removals took place between 6 months and 1 year post-fixation, with some cases being removed even within less than 3 months following fixation. It is generally advised that minipilates be removed after confirming bone healing, typically within 6 months to a year. The broad spectrum of miniplate removal times identified in this study can be attributed to a complex interplay of patient-specific elements, fracture characteristics, surgical techniques, healing rates, and potential complications. Tailored patient care, clinical discretion, and continuous evaluation are crucial for determining the optimal timing of plate removal to ensure optimal results. The mandible was the predominant site for miniplate removal, accounting for the majority (72.8%) of cases, particularly in the mandibular body and symphysis region. In a study by [PERSON] et al. [29], they found the mandibular angle region to be the primary location for miniplate removal (39.5%), while [PERSON] et al. [13] reported that the mandible was involved in 62.85% of hardware removal cases in the maxillofacial region. The increased tendency to remove miniplates from the mandible, as observed in our study and other research, may be linked to the mandible's denser cortical bone structure relative to other facial bones. Additionally, the main blood supply to the mandible originates from the inferior alveolar artery and periosteum, both of which are susceptible to damage during trauma and surgical procedures [15; 27]. Furthermore, the relatively thicker intraoral mucosa during surgical approaches heightens the risk of plate exposure. [PERSON] and colleagues [37] conducted an assessment of Champy titanium and stainless steel miniplates and screws used to stabilize mandibular fractures in an animal model. They retrieved these miniplates and screws at 4, 12, and 24 weeks after the surgery and concluded that there is no conclusive evidence supporting the routine removal of either titanium or stainless steel miniplates within six months following insertion. However, titanium tends to degrade over time due to wear and the release of particles. The resulting corrosion and wear byproducts, including metal ions or particles, can lead to tissue changes, ranging from fibrosis to infection and necrosis [38]. Given its superior corrosion resistance, non-carcinogenic nature, hypoallergenicity, non-toxicity, and excellent tissue compatibility, titanium hardware can be safely retained in the maxillofacial region [39]. However, the metallic composition (stainless steel or titanium) played a negligible role in the number of miniplates removed, as the removal count was equivalent for both materials [40].