Stability of bioresorbable plates following reduction of mandibular body fracture: Three-dimensional analysis

Abstract

Purpose: The recent development of bioresorbable bone plates and screws allows plates to be applied to the load-bearing regions of the mandible and to remain in place over time without the need for removal. We hypothesized that the stability of composite plates and screws forged from unsintered hydroxyapatite particles and poly-L-lactide (u-HA/PLLA) is comparable to that of standard titanium fixation systems for the reduction of fractures of load-bearing regions of the mandibular body. Materials and methods: 40 patients underwent open reduction and internal fixation of the fractured mandibular body with either a titanium or u-HA/PLLA bone plate. Cone-beam CT images were obtained immediately postoperatively and at 6-month follow-up, and were analyzed for positional changes of the affected mandible. Results: There were no significant differences in the postoperative positional changes of reference points between the titanium and u-HA/PLLA miniplates, except for that for the coronoid process (pvalue = 0.03). Multivariate regression analysis revealed no significant differences in spatial changes between the immediate postoperative and 6-month follow-up images, after adjusting for age and sex. Conclusion: The stability of bioresorbable u-HA/PLLA miniplates and screws was comparable to that of titanium miniplates and screws immediately postoperatively and at 6-month follow-up, following surgical reduction of fractures of load-bearing regions of the mandibular body. Bioresorbable osteosynthesis can be considered a viable alternative to titanium osteosynthesis. 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.