A Clinical Study of Biodegradable Plates and Screws in Oral and Maxillofacial Surgery

Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.

The Result of Mandible Fracture Fixations with Biodegradable Materials

PURPOSE: Traditionally, titanium miniplate has been used for rigid fixation of mandible fractures. However, the limitations of metal plate have been reported such as hypersensitivity, interference with the cranio-facial growth of growing child, secondary bone resorption around the plate, foreign body reaction, declination of primary callus formation, and bone atrophy, and so forth. Recently, biodegradable miniplate has been introduced and used as an alternative to the metal plate despite of its lower strength. This study evaluated the usefulness and stability of biodegradable plate and screw for treatment of mandible fractures. METHODS: In this study, 61 patients(92 areas) diagnosed as mandible fracture in the last 2 years have been reviewed. We used titanium plate and screw in 32 patients, and biodegradable plate and screw(INION?) in 29 patients. Stability of plates and screws, bony healing process and its side effects were observed by clinical and radiographic assessment. RESULTS: In the titanium material group, one of malocclusion, two of mouth opening limitation, three of pain, three of palpation were shown. The plate of six patients involved in these complications were removed. In the biodegradable group, two of mouth opening limitation, two of pain, one of localized wound infection were shown and one plate was removed secondarily. CONCLUSION: There was no statistical difference between two groups in bony healing and complication rates. Biodegradable implants show efficient stability during initial bone healing and low side effects in long-term follow up periods.

Surgical Fixation with Biodegradable Plate for the Treatment of Ankle Fractures

PURPOSE: The purpose of this article is to show the efficacy of a biodegradable plate for treating lateral malleolar fractures in the ankle joint. MATERIALS AND METHODS: The 20 patients who underwent an open reduction and internal fixation for lateral malleolar fractures in the ankle joint from February, 2006 to February, 2007 in our hospital were enrolled into the study. The average age of the patients was 49.7 years and the average follow-up period was 5.6 months. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer et al. RESULTS: Average radiological bone union time was 10.5 weeks. The clinical result was excellent in 19 cases (95%), good in 1 case (5%). There was one case of minimal displacement less than 1 mm, associated with anterior distal tibio-fibular ligament avulsion fracture. CONCLUSION: For proper patients, a biodegradable plate is an effecttive alternative implant for stabilizing lateral malleolar fractures in the ankle joint, because there is no requirement for subsequent removal and slow resorption in vivo.

Clinical and radiological comparison between titanium and biodegradable miniplate monocortical osteosynthesis in mandibular angle fractures

on the external oblique ridge around the fractured mandibular angle according to the principle of monocortical osteosynthesis by Champy. We compared the incidence of side effects and the degree of bony union at the mandibular inferior border in two different fixation methods. In conclusion, we have found that one miniplate regardless of matter could provide enough strength to grasp bony fragments of the tension site and compress the inferior border of mandible without any complications.