Bioabsorbable Osteofixation Materials for Maxillofacial Bone Surgery: A Review on Polymers and Magnesium-Based Materials

Abstract

Clinical application of osteofixation materials is essential in performing maxillofacial surgeries requiring rigid fixation of bone such as trauma surgery, orthognathic surgery, and skeletal reconstruction. In addition to the use of titanium plates and screws, clinical applications and attempts using bioabsorbable materials for osteofixation surgery are increasing with demands to avoid secondary surgery for the removal of plates and screws. Synthetic polymeric plates and screws were developed, reaching satisfactory physical properties comparable to those made with titanium. Although these polymeric materials are actively used in clinical practice, there remain some limitations to be improved. Due to questionable physical strength and cumbersome molding procedures, interests in resorbable metal materials for osteofixation emerged. Magnesium (Mg) gained attention again in the last decade as a new metallic alternative, and numerous animal studies to evaluate the possibility of clinical application of Mg-based materials are being conducted. Thanks to these researches and studies, vascular application of Mg-based biomaterials was successful; however, further studies are required for the clinical application of Mg-based biomaterials for osteofixation, especially in the facial skeleton. The review provides an overview of bioabsorbable osteofixation materials in maxillofacial bone surgery from polymer to Mg.

Research status of biodegradable metals designed for oral and maxillofacial applications: A review

“…Except for the mandible, the flat bones of the maxillofacial region usually bear a lower load than long bones [ 18 ]. Researchers have found that Mg-based alloy fixation provides sufficient mechanical strength for maxillofacial bone healing [ 75 ]. In vitro pull-out experiments showed that pure Mg and AZ31 Mg alloy screws have similar fixation strengths to stainless steel screws [ 18 ].…”

Change in Pull-Out Force during Resorption of Magnesium Compression Screws for Osteosynthesis of Mandibular Condylar Fractures

“…In recent years, magnesium alloys have been observed to have better mechanical properties than polymers used for osteosynthesis and still maintain the advantage of resorbability [ 31 , 32 ] and have also been used in bone regeneration for their biological proprieties [ 33 ]. However, it is known that the mechanical properties of magnesium implants are lower than those of medical titanium [ 23 ].…”

Use of biomaterials in scaphoid fracture fixation, a systematic review

“…The role of the scaphoid within the structure and the mechanics of the carpus, including steering and rotation of the longitudinal axis of the scaphoid is an important kinematic component to consider in J o u r n a l P r e -p r o o f scaphoid fracture repair. Bioabsorbable devices have recently been investigated with renewed vigour in bony fixation 10 , with orthopaedic surgery having a long history of using absorbable metals intraoperatively with mixed results 11 . However, the advantages of bioabsorbable material use in scaphoid fracture fixation have not been evaluated in the literature.…”