## 4 Discussion  
The use of miniplates for the fixation of facial bone fractures has gained popularity due to their effectiveness in achieving stability and facilitating rapid recovery. However, there are instances where the removal of these miniplates becomes necessary post-surgery due to various reasons. In this study, a total of 2240 patients were assessed, encompassing a wide range of age groups from pediatric patients to elderly individuals. The majority of studies showed a higher representation of male patients. The studies were conducted in various countries, potentially reflecting differences in healthcare practices and patient demographics. The rationales for plate removal varied across studies, spanning from infections and pain to more specific concerns such as plate exposure, growth issues, and considerations for prosthetic rehabilitation. These discrepancies highlight the intricacies of maxillofacial surgeries and how patient characteristics may influence the decision to remove plates. These differences also underscore the importance of thorough patient assessment and personalized interventions in these surgical procedures. The decision on whether to keep or remove miniplates utilized in maxillofacial surgery is frequently influenced by several factors, such as the patient's age, medical history, and the location and nature of the fracture. The presence of infection or exposure of the plate may necessitate removal, while the absence of complications might indicate that retaining the plates is a viable option. Our research findings indicate that the most common reason for miniplate removal was patient request, followed by tooth extraction and infection at the surgical site. This discovery aligns with prior studies that have identified infection as the primary driver for miniplate removal [5; 23]. Miniplates, positioned in sensitive submucosal tissues, are susceptible to environmental trauma and the forces generated during chewing, which can compromise their stability, lead to screw loosening, provoke inflammation, and increase the risk of infection. Insufficient suturing techniques and suboptimal cooling of bone during screw hole preparation have also been associated with miniplate failure due to infection. Patients involved in road traffic accidents, in particular, are at a higher risk of contaminated wounds and a heightened likelihood of future miniplate removal [24]. Infections linked to miniplates typically remain confined within the bone and seldom progress to osteomyelitislis or delayed union. When infection arises within the initial 6 weeks after fixation, conservative management involving pus drainage and antibiotic therapy may suffice to facilitate fracture healing while retaining the fixed bone. Once the fracture is stable and healed, miniplate removal may be performed. However, if the infection extends to the underlying operated bone and bony union is incomplete, miniplate removal followed by external fixation and bone grafting might be necessary. Infections can stem from oral cavity bacteria or improper aseptic techniques during surgery. [PERSON] et al. [12] documented 14 out of 105 miniplates being removed due to infection, while [PERSON] et al. [17] noted 12 out of 800 miniplates being removed for the same reason. In certain instances, infection can be attributed to tooth damage during the fixation surgery, the presence of teeth within the fracture line during trauma, or compromised blood supply in the edentulous mandible. However, when infection does not affect the bone, miniplates can be preserved through the application of antibiotics, cleaning, removal of infected tissue, and the elimination of infection sources. Small plates can harbor bacteria, which may lead to sustained inflammation and discomfort. Research indicates that the occurrence of infection in patients with retained small plates can reach up to 30% [25]. The probability of infection increases over time, implying that the longer a small plate remains within the body, the greater the likelihood of infection.