Recent advances in fixation of the craniomaxillofacial skeleton

Meslemani, Danny; Kellman, Robert M.

doi:10.1097/moo.0b013e3283543a9d

Cited by 24 publications

(15 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previously, craniofacial bone plates and screws have been fabricated from stainless steel, vitallium, chromium-cobalt, and other metal alloys [31]. Titanium has become the preferred permanent metal of choice due to its ability to osteointegrate [32]. However, it is estimated that 10–12% of craniofacial implants are removed due to infection, exposure, pain, and discomfort [32].…”

Section: Introductionmentioning

confidence: 99%

“…Titanium has become the preferred permanent metal of choice due to its ability to osteointegrate [32]. However, it is estimated that 10–12% of craniofacial implants are removed due to infection, exposure, pain, and discomfort [32]. Resorbable polymer plates and screws are becoming more popular to use for craniofacial implants because they allow for fixation and stabilization but are not permanent [32].…”

Section: Introductionmentioning

confidence: 99%

“…However, it is estimated that 10–12% of craniofacial implants are removed due to infection, exposure, pain, and discomfort [32]. Resorbable polymer plates and screws are becoming more popular to use for craniofacial implants because they allow for fixation and stabilization but are not permanent [32]. However, biodegradable polymers, such as poly-l-lactide, are biomechanically inferior to their metal counterparts [33].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Magnesium alloys as a biomaterial for degradable craniofacial screws

et al. 2014

View full text Add to dashboard Cite

Recently, magnesium (Mg) alloys have received significant attention as a potential biomaterial for degradable implants, and this study was directed at evaluating the suitability of Mg for craniofacial bone screws. The objective was to implant screws fabricated from commercially available Mg-alloys (pure Mg and AZ31) in-vivo in a rabbit mandible. First, Mg-alloy screws were compared to stainless steel screws in an in-vitro pull-out test and determined to have a similar holding strength (~40N). A finite element model of the screw was created using the pull-out test data, and the model can be used for future Mg-alloy screw design. Then, Mg-alloy screws were implanted for 4, 8, and 12 weeks, with two controls of an osteotomy site (hole) with no implant and a stainless steel screw implanted for 12 weeks. MicroCT (computed tomography) was used to assess bone remodeling and Mg-alloy degradation, both visually and qualitatively through volume fraction measurements for all time points. Histologic analysis was also completed for the Mg-alloys at 12 weeks. The results showed that craniofacial bone remodeling occurred around both Mg-alloy screw types. Pure Mg had a different degradation profile than AZ31, however bone growth occurred around both screw types. The degradation rate of both Mg-alloy screw types in the bone marrow space and the muscle were faster than in the cortical bone space at 12 weeks. Furthermore, it was shown that by alloying Mg, the degradation profile could be changed. These results indicate the promise of using Mg-alloys for craniofacial applications.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Magnesium alloys as a biomaterial for degradable craniofacial screws

et al. 2014

View full text Add to dashboard Cite

show abstract

“…A full discussion of all applications of PPF and resorable materials for mandibular fixation is outside the scope of this article, however, several excellent reviews currently exist. 31,32 The use of the dual-syringe system was tested in this study as it is envisioned to be used clinically. Fracture stabilization, especially of facial bones, has been a long-standing challenge for clinicians, and research in the past has focused on using degradable materials.…”

Section: Discussionmentioning

confidence: 99%

Characterization of an injectable, degradable polymer for mechanical stabilization of mandibular fractures

Henslee

Yoon

et al. 2014

J Biomed Mater Res

View full text Add to dashboard Cite

This study investigated the use of injectable poly(propylene fumarate) (PPF) formulations for mandibular fracture stabilization applications. A full factorial design with main effects analysis was employed to evaluate the effects of the PPF:N‐vinyl pyrrolidone (NVP, crosslinking agent) ratio and dimethyl toluidine (DMT, accelerator) concentration on key physicochemical properties including setting time, maximum temperature, mechanical properties, sol fraction, and swelling ratio. Additionally, the effects of formulation crosslinking time on the mechanical and swelling properties were investigated. The results showed that increasing the PPF:NVP ratio from 3:1 to 4:1 or decreasing the DMT concentration from 0.05 to 0.01 v/w % significantly decreased all mechanical properties as well as significantly increased the sol fraction and swelling ratio. Also, increasing the crosslinking time at 37°C from 1 to 7 days significantly increased all mechanical properties and decreased both the sol fraction and swelling ratio. This study further showed that the flexural stiffness of ex vivo stabilized rabbit mandibles increased from 1.7 ± 0.3 N/mm with a traditional mini‐plate fixator to 14.5 ± 4.1 N/mm for the 4:1 (0.05 v/w % DMT) PPF formulation at day 1. Overall, the formulations tested in this study were found to have properties suitable for potential further consideration in mandibular fracture fixation applications. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 103B: 529–538, 2015.

show abstract

“…9 Technological advances in intraoperative CT, better plating systems and new surgical instruments and operative techniques have improved our ability to adequately reduce and fix facial fractures and osteotomies. 10 With decreasing radiation doses, CT is likely to become the primary post-operative imaging modality among such patients.…”

Section: Discussionmentioning

confidence: 99%

CT of facial fracture fixation: an experimental study of artefact reducing methods

Peltola¹,

Mäkelä²,

Haapamäki³

et al. 2017

Dentomaxillofacial Radiology

View full text Add to dashboard Cite

Objectives: This study aimed to determine the optimal post-operative CT imaging method that enables best visualization of facial bony structures in the vicinity of osteosynthesis material. Methods: Conducted at Töölö Hospital (Helsinki, Finland), this study relied on scanning a phantom with CBCT, 64-slice CT and high-definition multislice CT with dual-energy scan (providing monochromatic images of 70-, 100-, 120-and 140-keV energy levels) and iterative reconstruction (IR) methods. Two radiologists assessed the image quality, and the assessments were analyzed. In addition, a physicist performed a semi-quantitative analysis of the metalinduced artefacts. Results: The three subjects most easily assessed were the loose screw and both the bone structure and the fracture further away from the screw and the plate. Soft tissues adjacent to the screw and the plate remained more difficult for assessment. Both image interpreters agreed that the artefacts disturbed their assessments under dual energy. Metal artefacts disturbed the least under multislice CT with IR [adaptive statistical iterative reconstruction (ASiR) and VEO]. Neither interpreter found metal suppression helpful in CBCT. Conclusions: CBCT with or without a metal artefact reduction algorithm was not optimal for post-operative facial imaging compared with multislice CT with IR. Multislice CT with ASiR filtering offered good image quality performance with fast image volume reconstruction, representing the current sweet spot in post-operative maxillofacial imaging.

show abstract

Recent advances in fixation of the craniomaxillofacial skeleton

Cited by 24 publications

References 23 publications

Magnesium alloys as a biomaterial for degradable craniofacial screws

Magnesium alloys as a biomaterial for degradable craniofacial screws

Characterization of an injectable, degradable polymer for mechanical stabilization of mandibular fractures

CT of facial fracture fixation: an experimental study of artefact reducing methods

Contact Info

Product

Resources

About