Comparing maximal forces in resorbable poly-L-lactic acid and titanium plates for mandibular fracture fixation

Abstract

Treatment for mandibular fractures is commonly performed via open reduction fixation with mini titanium or resorbable plates and screws. The investigators hypothesized differences in maximum mechanical stress forces and deflection with each plating material; however, it was proposed that the experimental forces withstood by the resorbable system would be enough to withstand normal forces produced during mastication.The sample was composed of fresh cadaver mandibles that were harvested, fractured, and fixated with plates and screws. The predictor variable was fracture fixation and included a titanium plating or resorbable poly-Llactide plating system. The primary outcome measure was maximum load withstood before plating failure measured in Newtons (N). Descriptive and bivariate statistics were computed, P value was set at .05.The sample was composed of six mandibles with and grouped by type of fixation modality, Titanium (T) (n ¼ 3) and Resorbable (n ¼ 3). There was a statistically significant correlation between the T group and increased maximum load (N) before failure as compared to the R group, (P ¼ 0.023).The results suggest that fracture fixation with titanium plates and screws can withstand greater maximum forces before failure; however, the resorbable plating system withstood forces similar to/or greater than the maximum forces produced during normal mastication.

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

“…Mandibular fractures are the most common facial fractures requiring surgical intervention, accounting for 41.6–75.2% [ 81 ], which affect the patient's occlusion, speech, and facial symmetry [ 82 ]. Mandibular fractures usually require open reduction fixation with rigid plates and screws [ 83 ]. In recent years, biodegradable Mg plates and screws used for mandibular fracture fixation and orthognathologic fixation have attracted the attention of researchers.…”

Resorbable Osteosynthesis in Mandibular Fractures. An Exploratory Systematic Review

“…Titanium plates and screws are currently considered the first option due to their operational benefits (5). However, over time it has been shown that their use brings possible complications related to their composition, material lifespan, interaction with the patient's tissues, disadvantages in certain groups, among others, given in the short, medium and long term (5,6). The search for new alternatives that minimize the problems that have arisen with their use in mandibular fractures has led to the creation of a resorbable biological material (4,5).…”

“…The search for new alternatives that minimize the problems that have arisen with their use in mandibular fractures has led to the creation of a resorbable biological material (4,5). Resorbable osteosynthesis is one of the most recent techniques used for the stabilization of mandibular bone fractures (6). These plates are made with polyglycolic acid, polylactic acid and their copolymers, biocompatible materials that are characterized by their ability to completely degrade over a period of 1 to 4 years (6).…”

“…Resorbable osteosynthesis is one of the most recent techniques used for the stabilization of mandibular bone fractures (6). These plates are made with polyglycolic acid, polylactic acid and their copolymers, biocompatible materials that are characterized by their ability to completely degrade over a period of 1 to 4 years (6). With the introduction of this technology, it was discovered that polylactic acid is not toxic, does not react with tissues, does not accumulate in vital organs and has a slow degradation process (6).…”

Evaluation of the Efficacy of SonicWeld Rx® System in Maxillofacial Fractures: A Clinical Study

“…(2) Poly-L-lactide (PLLA) and poly-D-lactide (PDLA) are a bioresorbable monomer which had developed since the early 1990s, PLLA has been used as a maxillofacial osteosynthesis material as "the rst generation" bioresorbable osteosynthetic material, but these two polymers had associated problems such as restorability period, foreign body reaction and electing an in ammatory response. (3) Copolymers of PGA, PLLA, and PDLA were preferred over pure PGA and PLLA as "the second generation" as rapidly bioresorbable osteosynthetic materials possessing amorphous structure with higher rate of hydration and hydrolysis. The copolymer is structured to provide adequate strength for 6-8 weeks and for a complete resorption time of 12-18 months, those products are really feasible in a clinical application for midfacial osteosynthesis as secure and rapid bioresorbable materials.…”