Biodegradable versus titanium plates and screws for paediatric facial skeleton fractures

Janickova, M.; Statelová, D; Mikušková, Katarína; Jesenak, M.; Malachovsky, I

doi:10.4149/bll_2018_100

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…With recent innovations in biotechnology, several bioresorbable alternatives have become commercially available. The results from using these innovative devices are comparable to those from using traditional titanium plates and screws [3,25,26,27,28,29]. Therefore, with the advantage of no removal requirement, biodegradable materials will soon replace titanium in the management of maxillofacial trauma or osteotomy, although they remain biomechanically weaker.…”

Section: Discussionmentioning

confidence: 99%

Bone Regeneration Potential of Uncalcined and Unsintered Hydroxyapatite/Poly l-lactide Bioactive/Osteoconductive Sheet Used for Maxillofacial Reconstructive Surgery: An In Vivo Study

et al. 2019

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Uncalcined and unsintered hydroxyapatite/poly l-lactide (u-HA/PLLA) material has osteoconductive characteristics and is available for use as a maxillofacial osteosynthetic reconstruction device. However, its bone regeneration ability in the maxillofacial region has not been fully investigated. This study is the first to assess the bone regenerative potential of osteoconductive u-HA/PLLA material when it is used for repairing maxillofacial bone defects. A total of 21 Sprague-Dawley male rats were divided into three groups—the u-HA/PLLA, PLLA, or sham control groups. A critical size defect of 4 mm was created in the mandible of each rat. Then, the defect was covered with either a u-HA/PLLA or PLLA sheet on the buccal side. The rats in each group were sacrificed at 2, 4, or 8 weeks. The rats’ mandibles were sampled for histological analysis with hematoxylin and eosin staining, histomorphometry, and immunohistochemistry with Runx2 and osteocalcin (OCN) antibody. The amount of newly formed bone in the u-HA/PLLA group was significantly higher than that of the PLLA group. The expression of Runx2 and OCN in the u-HA/PLLA group was also significantly higher. These results demonstrate that the u-HA/PLLA material has excellent bone regenerative ability and confirm its applicability as a reconstructive device in maxillofacial surgery.

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Section: Discussionmentioning

confidence: 99%

Bone Regeneration Potential of Uncalcined and Unsintered Hydroxyapatite/Poly l-lactide Bioactive/Osteoconductive Sheet Used for Maxillofacial Reconstructive Surgery: An In Vivo Study

et al. 2019

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“…Dentre as fraturas faciais, encontram-se nos pacientes infantis principalmente as fraturas de mandíbula e de maxila. De um total de 156 casos em crianças, as maiores prevalências dos ossos envolvidos nas fraturas faciais foram: mandíbula (corpo, côndilos, dentoalveolar, ângulo, sínfise e parassínfise) em 41,7% e face média (Le Fort, complexo zigomático, blow-out, naso-órbitoetmoidal e frontal) combinada em 61,2% 26 .…”

Section: Discussionunclassified

“…Microplacas e miniplacas de titânio oferecem melhoras iniciais de estabilidade, mas sua aplicação em crianças é limitada devido às preocupações sobre as restrições de crescimento, proteção contra tensões, corrosão e palpabilidade. Em contraste, a principal vantagem da fixação reabsorvível interna é a transferência gradual de carga para o osso em cicatrização durante a reabsorção, menor probabilidade de necessidade de operações secundárias para remoção do implante, bem como sem interferência ao adquirir tomografia computadorizada (TC) ou ressonância magnética (RM) 26,32 .…”

Section: Discussionunclassified

A tomada de decisão no uso de sistema de fixação absorvível em cirurgias bucomaxilofaciais: revisão sistemática

et al. 2021

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Introdução: As fraturas ósseas faciais são muito comuns em lesões de face, destacando-se as fraturas mandibulares. Para o tratamento delas é necessário haver um sistema de fixação a fim de restaurar o osso fraturado, sua forma e função. Objetivo: Identificar fatores influenciadores do uso de sistemas de fixação absorvíveis em cirurgias buco maxilo faciais. Material e método: Trata-se de uma revisão sistemática feita nas bases de dados MEDLINE, BBO e SciELO, no período de agosto de 2019 a setembro de 2020 nos portais da PubMed e BVS. Dentre os 322 achados e após utilização de filtros, leitura de títulos e resumos, foram incluídos 30 artigos para compor a revisão. Resultados: Os achados do estudo revelam existir uma série de fatores influenciáveis na escolha do melhor material, tais como: sua aplicação em pacientes pediátricos ou adultos, a palpabilidade das placas, a resistência, as principais medidas de satisfação, o envolvimento com doenças malignas, complicações e novidades que a literatura vem discutindo sobre o tipo de material. Conclusão: O uso de placas absorvíveis é aconselhado para uso pediátrico, pois minimizam as restrições ao crescimento, dispensam a necessidade de uma cirurgia secundária, reduzindo, assim, gastos hospitalares. Além disso, as placas biodegradáveis originam exames de imagem com menos artefatos, de modo que não comprometem diagnósticos em pacientes com neoplasias.

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“…Also, titanium miniplates became a routine mean of cranial bone fl ap fi xation (54), replacing osteosuture and achieving satisfactory results (54) including a reduced osteolysis and complication rate (25). In paediatric patients, biodegradable plates can be used to fi x both cranial bone fl aps (55) and dislocated injuries of maxillofacial skeleton, resulting in satisfactory mechanic and cosmetic results as well as in a low complication and reoperation rate (56). Other commonly used materials in cranial reconstructive surgery include polymethylmethacrylate (PMMA), polyetheretherketone (PEEK) or porous hydroxyapatite (55,57).…”

Section: Discussionmentioning

confidence: 99%

Analysis of clinical efficiency and early postoperative complications after cranioplasty

Hanko¹,

Cmarkova²,

Snopko³

et al. 2021

BLL

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INTRODUCTION: Despite of being considered a routine procedure, cranioplasty is associated with a substantial risk of failure, or postoperative complications. PATIENTS AND METHODS: Postoperative clinical course and rate of complications was assessed in patients undergoing cranioplasty during years 2015-2019 in a retrospective fashion. RESULTS: The most frequent condition requiring cranioplasty was a presence of bone defect after a decompressive craniectomy for traumatic brain injury (45 patients). Revision was needed in 9 cases (12.68 %), removal of the bone fl ap was necessary in 5 patients (7.04 %). The most common complication observed was an unintended intraoperative durotomy, occurring in 9 patients (12.68 %), which was, however, not associated with an increased risk of reoperation. Postoperative improvement of motor functions was observed in 7 patients (9.86 %). Improvement of consciousness occurred in 8 patients (11.27 %). Early cranioplasty was associated with signifi cantly higher odds for surgical revision, patients after previous craniectomy for traumatic brain injury had signifi cantly increased odds for the overall occurrence of complications. CONCLUSIONS: After a cranial reconstruction, complications with a various degree of severity may occur and even the result in need of the implant removal. Postoperative improvement of focal neuro-defi cit is possible as well as improvement on the level of patient's consciousness (Tab. 2, Fig. 2, Ref. 61).

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Biodegradable versus titanium plates and screws for paediatric facial skeleton fractures

Abstract: The implementation of biodegradable osteosynthetic materials is optimal for the treatment of fractures of the middle third of the facial skeleton, lower part of the upper third of the facial skeleton, mandibular body and parasymphysis (Tab. 3, Fig. 3, Ref. 31).

Cited by 8 publications

References 24 publications

Bone Regeneration Potential of Uncalcined and Unsintered Hydroxyapatite/Poly l-lactide Bioactive/Osteoconductive Sheet Used for Maxillofacial Reconstructive Surgery: An In Vivo Study

Bone Regeneration Potential of Uncalcined and Unsintered Hydroxyapatite/Poly l-lactide Bioactive/Osteoconductive Sheet Used for Maxillofacial Reconstructive Surgery: An In Vivo Study

A tomada de decisão no uso de sistema de fixação absorvível em cirurgias bucomaxilofaciais: revisão sistemática

Analysis of clinical efficiency and early postoperative complications after cranioplasty

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