The purpose of this study was to retrospectively evaluate and examine the incidence of complications using poly-L-lactic acid and polyglycolic acid (PLLA/PGA) copolymer plate system in maxillofacial osteosynthesis. The retrospective study included 87 patients (50 men, 37 women), who needed maxillofacial surgery. We examined the proportion of complications and their factors from clinical data. A comparison was also made for plate decomposition using the molecular weight of the plate without plate exposure and complications. Osteosynthesis sites healed in all patients. Ten cases (11.5%) showed plate exposure-related complications, with all occurring at intraoral surgical sites. There was no significant difference in molecular weight changes of plates in resorbable process. Statistical analysis of study variables between patients with and without exposed plates showed that the plate thickness was significantly associated with the risk of exposed plates (p < 0.05). The commercially available PLLA/PGA device could be a useful rapid resorbable material for maxillofacial osteosynthesis. When thick plates are used on the intraoral site, it may be necessary to pay attention to the complication of plate exposure. Even if exposure-related complications have occurred, resorption and degradation of this material proceeds, suggesting the ease of appropriate risk management.

BackgroundThis study aimed to identify (1) the predilection site of postoperative infection after third molar extraction surgery, (2) risk factors associated with postoperative infection, and (3) the cause of the difference between delayed- and early-onset infections.Material and MethodsThis retrospective study included 1010 patients (396 male, 614 female) who had ≥1 third molars extracted (2407; 812 maxilla, 1595 mandible). The risk factors were classified as attributes, general health, anatomic, and operative. Outcome variables were delayed- and early-onset infections.ResultsPostoperative infection was completely absent in the maxilla, and all infections occurred in the mandible, with a probability of 1.94% (31/1595). Bivariate analysis for postoperative infection showed depth of inclusion and intraoperative hemostatic treatment to be significantly associated with the development of infections. Bivariate analysis for delayed- and early-onset infections showed simultaneous extraction of the left and right mandibular third molars to be prominent risk factors.ConclusionsPostoperative infection occurs mainly in the mandible, and that in the maxilla is very rare. The risk of postoperative infection in the mandible was found to be related to the depth of inclusion and intraoperative hemostatic treatment. Simultaneous extraction of the left and right mandibular third molars appear to increase the risk of delayed-onset postoperative infection. Key words:Third molar extraction surgery, delayed-onset infection, early-onset infection, postoperative infection.

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The purpose of this study was to assess the level of accuracy that can be achieved in patients undergoing orbital reconstruction for orbital fl oor defect accompanied by midfacial fracture using an unsintered hydroxyapatite particles/ poly-L-lactide composite plate system with and without the use of intraoperative navigation. Eight consecutive patients treated using the u-HA/PLLA mesh plate system between 2014 and 2016 were included in this retrospective study. We analyzed the clinical and radiological data of these patients with orbital fl oor defect and midfacial fracture extending to the orbit. We examined the patients' postoperative healing status, including visual activity, diplopia, and enophthalmos. The overall volume of the orbit was calculated in cubic millimeters and was compared between the reconstructed orbit and the uninjured orbit for with and without the use of navigation groups. No patients complained of visual problems, and no further treatment was required postoperatively. Except for one patient with persistence of slight supraversion diplopia in the group without navigation, all the preoperative diplopia symptoms postoperatively improved, and none of the patients complained of problems in daily living. There was a signifi cant diff erence (p < 0.05) in the mean reconstructed orbital volume accuracy between with and without navigation. In conclusion, complex orbital reconstruction using optimal bioactive/resorbable material with intraoperative navigation is an accurate and reliable method of reconstruction.

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