• Title/Summary/Keyword: Bioabsorbable

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Bioabsorbable osteofixation for orthognathic surgery

  • Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.6.1-6.9
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    • 2015
  • Orthognathic surgery requires stable fixation for uneventful healing of osteotomized bony segments and optimal remodeling. Titanium plates and screws have been accepted as the gold standard for rigid fixation in orthognathic surgery. Although titanium osteofixation is the most widely used approach, the use of bioabsorbable devices has been increasing recently. Biodegradation of bioabsorbable devices eliminates the need for a second operation to remove metal plates and screws. However, long-term stability and relapse frequency in bioabsorbable osteofixation are still insufficiently studied, especially in cases of segmental movements of great magnitude or segmental movements to a position where bony resistance exists. This paper reviews the background, techniques, and complications of bioabsorbable osteofixation and compares bioabsorbable and titanium osteofixation in orthognathic surgery in terms of skeletal stability.

Application of Bioabsorbable Plates in Orthognathic Surgery

  • Kim, Young-Kyun;Shim, Cheong-Hwan;Bae, Ji-Hyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.1
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    • pp.60-64
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    • 2006
  • Backgrounds: Though they are considered as reliable devices, titanium plates and screws have limitations due to some potential problems. To overcome these problems, researches on bioabsorbable materials for internal fixation have been continuing. Recently, there are many clinical trials to apply biodegradable internal fixation devices in oral and maxillofacial surgery. The purpose of this study was to evaluate the clinical results of application of bioabsorbable plates and screws in orthognathic surgery. Methods: Fifty-four patients with dentofacial deformity (17 male patients and 37 female patients) were selected in this study. The patients were treated by internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm pretapped screws (Biosorb FX, Bionix Implants, Inc., Finland). The patients were evaluated for complications during the follow-up period. Results: Five patients (9.3%) experienced complications. All complications in these cases were infection. No other complications related with physical or mechanical properties of bioabsorbable plates were found such as malunion or nonunion, fractures of plates and loosening of screws. All complications were minor and adequately managed with drainage and supportive care with antibiotics coverage. Conclusions: From the results, the use of these fixation systems in orthognathic surgery will provide a promising alternative titanium fixation in appropriate cases.

Cephalometric evaluation of skeletal stability and pharyngeal airway changes after mandibular setback surgery: Bioabsorbable versus titanium plate and screw fixation

  • Phu Hnin Thet;Boosana Kaboosaya
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.181-190
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    • 2024
  • Purpose: This study compared sequential changes in skeletal stability and the pharyngeal airway following mandibular setback surgery involving fixation with either a titanium or a bioabsorbable plate and screws. Materials and Methods: Twenty-eight patients with mandibular prognathism undergoing bilateral sagittal split osteotomy by titanium or bioabsorbable fixation were randomly selected in this study. Lateral cephalometric analysis was conducted preoperatively and at 1 week, 3-6 months, and 1 year postoperatively. Mandibular stability was assessed by examining horizontal (BX), vertical (BY), and angular measurements including the sella-nasion to point B angle and the mandibular plane angle (MPA). Pharyngeal airway changes were evaluated by analyzing the nasopharynx, uvula-pharynx, tongue-pharynx, and epiglottis-pharynx (EOP) distances. Mandibular and pharyngeal airway changes were examined sequentially. To evaluate postoperative changes within groups, the Wilcoxon signed-rank test was employed, while the Mann-Whitney U test was used for between-group comparisons. Immediate postoperative changes in the airway were correlated to surgical movements using the Spearman rank test. Results: Significant changes in the MPA were observed in both the titanium and bioabsorbable groups at 3-6 months post-surgery, with significance persisting in the bioabsorbable group at 1 year postoperatively (2.29°±2.28°; P<0.05). The bioabsorbable group also exhibited significant EOP changes (-1.21±1.54 mm; P<0.05) at 3-6 months, which gradually returned to non-significant levels by 1 year postoperatively. Conclusion: Osteofixation using bioabsorbable plates and screws is comparable to that achieved with titanium in long-term skeletal stability and maintaining pharyngeal airway dimensions. However, a tendency for relapse exists, especially regarding the MPA.

TREATMENT OF MANDIBLE FRACTURES USING BIOABSORBABLE PLATES: PRELIMINARY STUDY (생흡수성판을 이용한 하악골 골절의 치료 : 일차보고)

  • Kim, Young-Kyun;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.570-575
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    • 2001
  • This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients(18.5%) experienced complications. These included infection (four patients), and premature occlusal contact(one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.

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Dorsal Wedge Osteotomy Using Bioabsorbable Pins for the Treatment of Freiberg's Disease (중족골두 무혈성 괴사에서 생체흡수성 핀으로 고정한 배측 쐐기 절골술)

  • Gong, Hyun-Sik;Baek, Goo-Hyun;Kim, Ji-Hyeong;Chung, Moon-Sang
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.59-63
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    • 2005
  • Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.

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Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates

  • Doh, GyeongHyeon;Bahk, Sujin;Hong, Ki Yong;Lim, SooA;Han, Kang Min;Eo, SuRak
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.143-147
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    • 2018
  • We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

The Delayed Inflammatory Reaction after Anterior Cruciate Lligament Reconstruction with a Bioabsorbable Interference Screw Fixation - A Case Report - (생분해성 간섭나사를 이용한 전방십자인대 재건술 후 발생한 지연성 염증반응 - 증례 보고 -)

  • Lim, Hong-Chul;Noh, Kyoung-Sun;Yang, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.87-90
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    • 2006
  • The complication caused by a bioabsorbable interference screw is rare after anterior cruciate ligament reconstruction. We report a case of delayed inflammatory reaction at the tibial tunnel and femoral tunnel where the graft tendon had been fixed with a bioabsorbable interference screw ($Bioscrew^{(R)}$) for anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft.

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Pretibial Ganglion after Anterior Cruciate Ligament Reconstruction with Bioabsorbable Interference Screw fixation $(Bioscrew^{\circledR})$ - A Case Report - (생분해성 간섭나사를 이용한 전방 십자 인대 재건술 후 발생한 결절종 - 증례보고 -)

  • Song, Eun-Kyoo;Shim, Sang-Don;Kim, Myung-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.188-191
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    • 2002
  • The complication caused by a bioabsorbable interference screw composed of Poly-L-Lactic-Acid is rare after anterior cruciate ligament (ACL) reconstruction. We reported a case of a pretibial ganglion at the orifice of the tibial tunnel where the graft tendon had been fixed with a bioabsorbable interference screw $(Bioscrew^{\circledR})$ for ACL reconstruction using autogenous hamstring tendon. The patient was underwent ganglion excision and interference screw removal.

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A Comparative Study of the Subjective Symptoms of Bioabsorbable and Metallic Osteofixation System in Zygomatic Bone Fracture (흡수성과 비흡수성 내고정물 사용 후 관골 골절 환자의 자각증상의 차이)

  • Park, Woo Jin;Shin, Hye Kyoung
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.227-230
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    • 2005
  • The surgical treatment of craniofacial disorders, using metallic internal osteofixation system has inspired an evolution with advanced operative technique and fixation devices over past two decades. As any other surgical procedures, this procedure also associates problems such as infection, palpability, loosening, and restrict craniofacial skeleton growth, which lead to undue secondary operations for removal. These problems are improved by using bioabsorbable osteofixation system. We compared the patient's subjective symptoms using bioaborbable system versus metallic osteofixation system in zygomatic bone fracture. we should take the individual steps (postoperative 2 weeks, and 1 year) in treating fractured zygoma. From August, 2001 to August, 2003, we used bioabsorbable osteofixation system in 28 patients in zygomatic fracture ($Biosorb^{TM}FX^{(R)}$) and compared 23 patients who were treated with metallic osteofixation system. There was no significant difference in the both groups in subjective symptoms and postoperative result.