CLINICAL STUDY OF RESORBABLE PLATE AND SCREW FOR TREATMENT OF MAXILLOFACIAL FRACTURES

악안면 골절 치료시 흡수성 고정판의 사용에 관한 임상 연구

  • Jeong, Jong-Cheol (Dept. of Oral and Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Choi, Se-Hoon (Dept. of Oral and Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Song, Min-Soek (Dept. of Oral and Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Jun, Chang-Hun (Dept. of Oral and Maxillofacial Surgery, Gachon Medical School, Gil Medical Center) ;
  • Kim, Hyun-Min (Dept. of Oral and Maxillofacial Surgery, Gachon Medical School, Gil Medical Center)
  • 정종철 (가천의과대학교 길병원 구강악안면외과) ;
  • 최세훈 (가천의과대학교 길병원 구강악안면외과) ;
  • 송민석 (가천의과대학교 길병원 구강악안면외과) ;
  • 전창훈 (가천의과대학교 길병원 구강악안면외과) ;
  • 김현민 (가천의과대학교 길병원 구강악안면외과)
  • Published : 2003.12.31

Abstract

Purpose : This study evaluated the usefulness of resorbable plate and screw for treatment of maxillofacial bone fractures. Patients and methods : From july, 2000 to july, 2002, we used resorbable plates and screws($Biosorb^{(R)}$ FX, Bionix Inc, Finland) on 126 patients for treatment of maxillofacial bone fractures. Among them, 80 patients were capable of periodic following up to present season. We evaluated these patients with clinical, radiographic findings and subjective satisfaction. Results : 80 patients composed of 63 men and 17 women. Complication rates are 7.5%(6/80) recorded. 1 of bulging sensation, 3 of infection sign, 2 of the plate detachment were shown. The plates involved in such complications were removed. The other patients(92.5%) were not shown any problems. We could not find complete resorption of screw holes in the mandibular symphysis area even though two years later after surgery. Conclusion : Bioresorbable plates and screws are useful as fixation material at maxillofacial fractures although strength is thought to be weaker than titanium plate. But to reduce the possible complicaions, need to careful clinical and radiographical evaluations.

Keywords

References

  1. Alpert B, Seligson D: removal of asymptomatic bone plate used for orthognathic surgery and facial fractures. J Oral Maxillofac Surg. 1996;54(5):618-621. https://doi.org/10.1016/S0278-2391(96)90645-X
  2. Kim YK, Yeo HH, Lim SC: Tissue response to titanium plates; A transmitted electron microscopic study. J Oral Maxillofac Surg. 1997;55(4):322-326. https://doi.org/10.1016/S0278-2391(97)90115-4
  3. Ellis E III, Walker LR: Treatment of mandibular angle fractures using on noncompression miniplate. J Oral Maxillofac Surg 1996;54:864-872. https://doi.org/10.1016/S0278-2391(96)90538-8
  4. Suuronen R, Ashammakhi N, Peltoniemi H, Waris E, Serlo W, Kellomaki M, Tormala P, Waris T: Developments in Craniomaxillofacial Surgery: Use of Self-Reinforced Bioabsorbable Osteofixation Devices. Plast Recon Surg 2001 July; 108(1):167-180. https://doi.org/10.1097/00006534-200107000-00027
  5. Cutright DE, Hunsuck EE, Beasley JD: Fracture reduction using a biodegradable material, polylactic acid. J Oral Surgery 1971;29:393-7.
  6. Suuronen R, Manninen MJ, Pohjonen T, Laitinen O, Lindqvist C: Mandibular osteotomy fixed with biodegradable plate and screw:an animal study. Brit J Oral Maxillofac Surg 1972;4:341-347.
  7. Suuronen R, Kallela I, Laine P, Ranta P, Iizuka T, Lindqvist C: Osteotomy site healing following mandibular sagittal split osteotomy and rigid fixation with polylactide biodegradable screws. Int J Oral Maxillofac Surg 1999 June; 28(3):166-170. https://doi.org/10.1016/S0901-5027(99)80130-1
  8. Suuronen R, Peltoniemi H, Ashammakhi N, Kontio R, Waris T, Salo A, Lindqvist C, Gratz K: The use of bioabsorbable osteofixation devices in craniomaxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Rad Endodont 2002 July; 94(1):5-14. https://doi.org/10.1067/moe.2002.122160
  9. 류동목, 박현욱, 이한주, 허원실 : 흡수성고정판이 가토 악골골절의 치유에 미치는 영향. 대한악안면성형재건외과학회지 1999;21.vol 2:131-138.
  10. Suuronen R, Ashammakhi N, Tiainen J, Tormala P, Waris T: Spotlight on Naturally Absorbable Osteofixation Devices. J Craniofac Surg 2003 March ;14(2):247-259. https://doi.org/10.1097/00001665-200303000-00021
  11. Suuronen R, Kallela I, Lindqvist C : Bioabsorbable screw: Current state of the art in facial fracture repair. J craniomaxillofac Trauma 2000;6(1):19-27.
  12. Ascherman J, Knowles S, Marin V, Prisant N: Cranial Reossification with absorbable plates. Plast Reconst Surg 2001;107:763-768. https://doi.org/10.1097/00006534-200103000-00017
  13. Bostman O, Hirvensalo E, Makinen J, Pokkanen P: Foreign body reactions to fracture fixation implants of biodegradable synthetic polymer. J Bone Joint Surg 1990;72-B: 592-6. https://doi.org/10.1302/0301-620X.72B4.2199452
  14. Bostman O: Osteolytic changes accompanying degradation of absorbable fracture fixation implants. J Bone Joint Surg 1991;73-B:679-82. https://doi.org/10.1302/0301-620X.73B4.1649195
  15. Edwards RC, Kiely KD, Eppley BL: The fate of resorbable poly-L-lactic/ polyglycolic acid bone fixation devices in orthognathic surgery. J Oral Maxillofac Surg 2001;59:19-25. https://doi.org/10.1053/joms.2001.19267
  16. Harada K, Enomoto S: Stability after surgical correction of mandibular prognathism using the sagittal split ramus osteotomy and fixation with poly-L-lactic acid screws. J Oral Maxillofac Surg 1997;55:464-468. https://doi.org/10.1016/S0278-2391(97)90691-1
  17. Harada K, Enomoto S: Stability after surgical correction of mandibular prognathism using the sagittal split ramus osteotomy and fixation with poly-L-lactic acid screws. J Oral Maxillofac Surg 1997;55:464-468. https://doi.org/10.1016/S0278-2391(97)90691-1
  18. Bessho KB, Ilzuka T, Murakami KI: A bioabsorbable poly-l- lactic acid miniplate and screw system for osteosynthesis in oral and maxillofacial surgery. J Oral Maxillofac Surg 55:941-945,1997.
  19. Bergma EJ, Rozema FR, Bos RRM: Foreign body reaction to resorbable poly(L-lactic acid) bone plates and screws used for the fixation of unstable zygomatic fractures. J Oral Maxillofac Surg 51:666-670,1993.
  20. Landes CA, Kriener S, Menzer M, Kovacs AF: Resorbable plate osteosynthesis of dislocated or pathological mandibular fractures: A prospective clinical trial of two amorphous L-/DL-Lactide copolymer 2-mm miniplate systems. Plast Reconstr Surg 111(2):601-610, 2003. https://doi.org/10.1097/01.PRS.0000041942.36666.4F
  21. Shetty V, Caputo AA, Kelso I: Torsion-axial force characteristics of SR-PLLA screws. J Cranio Maxilofac Surg 1997;25:19-23. https://doi.org/10.1016/S1010-5182(97)80020-0
  22. Kallela I, Iizuka T, Salo A, Lindqvist C: Lagscrew fixation of anterior mandibular fracture using biodegradable polylactide screw: a preliminary report. J Oral Maxillofac Surg 1999;57:113-118. https://doi.org/10.1016/S0278-2391(99)90220-3
  23. Kim YK, Kim SG: Treatment of mandibular fracture using bioresorbable plates. Plast Reconstr Surg 2002;110:25-31. https://doi.org/10.1097/00006534-200207000-00006
  24. Tuovinen V, Norholt SE, Sindet-pedersen S, Jensen J: A retrospective analysis of 279 patients with isolated mandibular fractures treated with titanium. J Oral Maxillofac Surg 1994;52:931-935. https://doi.org/10.1016/S0278-2391(10)80072-2