A prospective trial of poly-L-lactic/polyglycolic acid co-polymer plates and screws for internal fixation of mandibular fractures.

Abstract

The aim of this study was to test the performance of poly-L-lactic/polyglycolic acid (PLLA/PGA) co-polymer plates and screws in the fixation of mandibular fractures. Following clinical and radiographic examination, internal fixation was achieved with PLLA/PGA co-polymer plates and screws in 31 patients. Elastic maxillomandibular fixation was maintained for 4 weeks and a blenderized diet for 6 weeks. Patients were followed up at 1 week, 6 weeks, and 3, 6 and 12 months post surgery, and evaluated clinically for swelling, pain, mucosal discoloration and occlusal relation. Segment stability, fracture healing and screw-hole ossification were assessed radiographically. Of the 29 patients who completed the trial, 20 had an uncomplicated postoperative period, resulting in complete bone union. Radiographic evidence of screw-hole ossification was noted in several patients, with considerable site-dependent rate variation. Nine patients developed complications ranging from minor dehiscence (4 patients) to frank sepsis requiring plate removal (5 patients), resulting in a 22.5% complication rate. There were no cases of non-union at the end of the fixation period. The reported complication rate following titanium internal fixation of mandibular fractures is 13.7%-43%. PLLA/PGA co-polymer plate and screw fixation of mandibular fractures, although technically more challenging and costly, is a viable alternative to traditional metal devices in selected patients.

• Authors: C Ferretti
• Journal: International journal of oral and maxillofacial surgery (Int J Oral Maxillofac Surg) Vol. 37 Issue 3 Pg. 242-8 (Mar 2008) ISSN: 0901-5027 [Print] Denmark
• PMID: 18295449 (Publication Type: Journal Article)

Chemical References

• Biocompatible Materials
• Polylactic Acid-Polyglycolic Acid Copolymer
• Polyglycolic Acid
• Lactic Acid

Topics

• Absorbable Implants
• Adolescent
• Adult
• Biocompatible Materials (chemistry)
• Bone Plates
• Bone Screws
• Device Removal
• Edema (etiology)
• Female
• Follow-Up Studies
• Fracture Fixation, Internal (instrumentation)
• Fracture Healing
• Humans
• Jaw Fixation Techniques
• Lactic Acid (chemistry)
• Male
• Mandibular Fractures (surgery)
• Middle Aged
• Mouth Diseases (etiology)
• Osteogenesis (physiology)
• Pain, Postoperative (etiology)
• Polyglycolic Acid (chemistry)
• Polylactic Acid-Polyglycolic Acid Copolymer
• Postoperative Complications
• Prospective Studies
• Surgical Wound Dehiscence (etiology)
• Surgical Wound Infection (etiology)