Introduction:In recent years, bioresorbable plates have undergone remarkable development. However, there has been no attendant improvement in their strength, because strength requires thickness, and complications such as palpability are related to the thickness of bioresorbable plate systems. In this clinical study, we compared the surgical management of zygomatic fractures using newly developed thinner bioresorbable materials or conventional titanium miniplates.Methods:Twelve patients with zygomatic fractures were randomly divided equally into 2 groups (6 with new bioresorbable osteosynthesis materials and 6 with standard titanium miniplates). Using computed tomography, we evaluated the thickness of the soft tissue and plate at the zygomaticofrontal sutures in each patient with the help of detailed radiographic computed tomography data at 6 months postoperatively. We compared the amount of soft-tissue volume increase between the uninjured healthy and injured operated sides in each patient.Results:Both groups eventually achieved satisfactory healing, with a favorable restoration of form and function and without any complications, including palpability. The amount of soft-tissue volume increase at the operated side relative to the uninjured healthy side using new thin bioresorbable plates was 131.1% (range: 101.5–165.8). On the other hand, that of titanium miniplates was 126.4% (range: 102.2–167.6). There was no statistically significant difference (P > 0.05).Conclusion:This newly developed thinner flat-type bioresorbable plate system could be considered clinically useful in the treatment of zygomatic fractures even in easily palpated areas, such as the infraorbital rim or zygomaticofrontal sutures, without any healing differences in skeleton as compared with conventional titanium miniplates.
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.
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