BackgroundThe use of titanium during maxillofacial fixation is limited due to its palpability, mutagenic effects and interference with imaging, which lead to the requirement for subsequent removal. The use of a biologically absorbable fixation material will potentially eliminate these limitations. In this meta-analysis, we analyzed the complications of absorbable fixation in maxillofacial surgery.MethodsWe performed a systematic search of PubMed, Embase, Cochrane Central Register of Systematic Reviews and Cochrane Central Register of Controlled Trials for trials published through December 2012. Data extracted from literature were analyzed with Review manager 5.0.24.ResultsRelevant data was extracted from 20 studies (1673 participants) and revealed that patients in the absorbable group had significantly more complications than those in the titanium group (RR = 1.20; 95% CI: 1.02–1.42; P = 0.03) in all enrolled maxillofacial surgeries. For bimaxillary operation subgroup, the absorbable fixation group did not have a significant increase in complications when compared with the titanium group (RR = 1.89; 95% CI: 0.85–4.22; P = 0.12). There was no significant difference observed between the absorbable and titanium groups receiving a bilateral sagittal split ramus osteotomy (BSSRO) (RR = 1.45; 95% CI: 0.84–2.48; P = 0.18) and Le Fort I osteotomy (RR = 0.65; 95% CI: 0.34–1.23; P = 0.18). The combined results of the five trials revealed that the absorbable group had a significantly lower rate of complications compared to the titanium group (RR = 0.71; 95% CI: 0.52–0.97; P = 0.03) in fracture fixation.ConclusionThis meta-analysis shows that absorbable fixation systems used for fixation in maxillofacial surgery do not have adequate safety profiles. Subgroup indicated the safety of absorbable fixation systems was superior during fracture fixation. The absorbable fixation systems tend to have a similar favorable safety profile as titanium fixation during Le Fort I, bimaxillary operation and BSSRO.

In most patients, a conservative surgery will achieve good functional and aesthetic results. For patients with mild symptoms, the aesthetic effect should be given priority while for the heavier patients the restoration of function and aesthetic effects should all be taken into account.

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Parry-Romberg syndrome (PRS) is a rare craniofacial disorder whose etiology has not been well understood. The objective of this study was to evaluate the sex difference and the scope of female predominance in PRS. The study used meta-analysis to examine 838 diverse patients from 26 articles. The result of the study showed a significantly higher risk in women in the PRS study populations; the pooled female ratio was 2.23 (95% confidence interval, 1.77-2.80; P < 0.00001; N = 838 patients). There was no significant difference in the association between laterality of PRS and sex, wherein female and male patients have almost the same distribution of left- and right-sided PRS.