Skeletal stability and morbidity with self-reinforced P (L/DL) LA resorbable osteosynthesis in bimaxillary orthognathic surgery.

Abstract

INTRODUCTION:

We present a retrospective study of 30 consecutive cases of bimaxillary orthognathic surgery with biodegradable self-reinforced poly-L/DL-lactide plates and tacks, for the same indication of Angle class III malocclusion. We reported the skeletal stability and morbidity at 1 year after surgery.

PATIENTS AND METHODS:

All patients underwent bimaxillary procedure. We used self-reinforced poly-L/DL lactic acid copolymer. Stabilization of Lefort I osteotomy was achieved by four plates L-shaped. Sagittal split osteotomies were fixed by two straight-plates. Lateral cephalograms were taken before (T0), soon after (T1) and more than 1 year after surgery (T2). Eight standard landmarks and four angular measurements were taken into account. All differences of the landmarks and angles were measured at T1 and T2. The regular clinical follow-up was scheduled for a minimum period of 1 year.

RESULTS:

The mean advanced maxillary was 3.33 mm and the mean mandibular setback was 6.13 mm. The mean mandibular relapse was 2.2 mm (non-significant). Horizontal maxilla mean variation was 0.8 mm at 1 year at A-point. Vertical maxilla stability depends on maxillary movements: impaction stability is better as an isolated advancement or associated with pull-down movement. We found six inflammatory reactions and two of them need the removal of the plates.

CONCLUSION:

Bimaxillary orthognathic procedure with bioresorbable osteosynthesis is a reliable and reproducible method. Angle class III malocclusions could be entirely and successfully managed with bioresorbable osteosynthesis. The stability and suites at 1 year are comparable to titanium osteosynthesis.

• Authors: Christophe Moure, Quentin Qassemyar, Olivier Dunaud, Cecilie Neiva, Sylvie Testelin, Bernard Devauchelle
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 40 Issue 1 Pg. 55-60 (Jan 2012) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 21514172 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Polylactic Acid-Polyglycolic Acid Copolymer
• Polyglycolic Acid
• Lactic Acid

Topics

• Absorbable Implants
• Adolescent
• Adult
• Anatomic Landmarks
• Bone Nails
• Bone Plates (adverse effects)
• Cephalometry
• Female
• Follow-Up Studies
• Humans
• Jaw Fixation Techniques (adverse effects, instrumentation)
• Lactic Acid
• Male
• Malocclusion, Angle Class III (surgery)
• Orthognathic Surgical Procedures (instrumentation, methods)
• Osteotomy, Le Fort (adverse effects, instrumentation, methods)
• Osteotomy, Sagittal Split Ramus (adverse effects, instrumentation, methods)
• Polyglycolic Acid
• Polylactic Acid-Polyglycolic Acid Copolymer
• Retrospective Studies
• Secondary Prevention
• Statistics, Nonparametric
• Young Adult