Comparison of the Biomechanical Stiffness of Titanium and Sonic Weld RX Osteofixation Systems for Monoblock Zygomaticomaxillary Complex Fractures

Abstract

Resorbable osteosynthesis systems are widely used for the fixation of zygomaticomaxillary complex (ZMC) fractures instead of titanium systems, because they do not have postoperative hardware-related complications. However, the strength of conventional resorbable systems is inferior to that of titanium systems. Recently, ultrasound-aided resorbable osteosynthesis systems, which have higher fixation than conventional resorbable osteosynthesis systems, have become available.The purpose of this study was to compare the mechanical stiffness of the ultrasound-aided resorbable and titanium osteosynthesis systems in a cadaveric monoblock ZMC fracture model. Three human cadaveric monoblock ZMC fracture models (6 zygomas) were created. The fixation materials included the titanium (Level One Fixation; KLS Martin, Germany) and ultrasound-aided resorbable osteofixation systems (SonicWeld RX; KLS Martin). The fixation methods included the 3-point (zygomaticofrontal [ZF], zygomaticomaxillary buttress, and inferior orbital rim [Group I]) and the 2-point (ZF þ inferior orbital rim [Group IIa] and ZF þ zygomaticomaxillary buttress [Group IIb]) fixations. Each fixation model was mechanically tested with a load of up to 100 N, based on the previously reported postoperative masseter muscle strength, and the stiffness was calculated. Titanium was found to be stiffer than SonicWeld RX, though not significantly different. The fixation points in decreasing order of stiffness were Group I, Group IIa, and Group IIb, though the differences were not significant. In conclusion, the 2-point fixation, including the ZF fixation with SonicWeld RX, can be used as an alternative to the 3-point titanium fixation, which is considered to be stronger and stiffer.

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

“…These results are in the same direction with Dubina et al, 2013 (12) who reported that neither of their cases met a change transplant and implant con guration, nor displaced plates and pins. The rigid xation of bone fragments was observed in their study, over and above Iwanaga et al, 2021 (13) stated in his study when compared the biomechanical stiffness of titanium and SonicWeld Rx ® osteo xation systems for monoblock zygomaticomaxillary complex fractures that there was no statical difference between the two systems.…”

Advances and Prospects in Materials for Craniofacial Bone Reconstruction

“…), alloys, as well as the more commonly used titanium mesh (TM) and the composites therein have been applied to clinical practice. − Besides, in recent years more advanced resorbable materials with sufficient strength and moderate degradation rate have emerged, which is especially meaningful in the craniofacial bone repair species of pediatric and adolescent patients, considering the development of craniofacial bone in growing children. The main absorbable materials currently used in craniomaxillofacial surgery are aliphatic polyesters, such as RapidSorb (PLLA), Polymax (P­(L/DL) LA), etc. − Fewer resorbable products with osteoconductive activity, such as PLLA-μHA complexes (FIXSORB MX), are available. − In recent years, modifications of titanium mesh, , biodegradable alloys such as magnesium alloys, , addition of coatings with antimicrobial or biocompatible properties on the surface of the alloy, materials that can deform with children’s bone development, , and other patented designs try to make up for the shortcomings of the existing materials on the market, and resorbable composites that combine the advantages of a variety of materials themselves have become a current research hotspot and a trend in the development of bone repair materials.…”