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Zhang C, Hayashi K, Ishikawa K. Osseointegration enhancement by controlling dispersion state of carbonate apatite in polylactic acid implant. Colloids Surf B Biointerfaces 2023; 232:113588. [PMID: 37844475 DOI: 10.1016/j.colsurfb.2023.113588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
Osteoconductive ceramics (OCs) are often used to endow polylactic acid (PLA) with osseointegration ability. Conventionally, OC powder is dispersed in PLA. However, considering cell attachment to the implant, OCs may be more favorable when they exist in the form of aggregations, such as granules, and are larger than the cells rather than being dispersed like a powder. In this study, to clarify the effects of the dispersion state of OCs on the osseointegration ability, carbonate apatite (CAp), a bone mineral analog that is osteoconductive and bioresorbable, powder-PLA (P-PLA), and CAp granule-PLA (G-PLA) composite implants were fabricated via thermal pressing. The powder and granule sizes of CAp were approximately 1 and 300-600 µm, respectively. G-PLA exhibited a higher water wettability and released calcium and phosphate ions faster than P-PLA. When cylindrical G-PLA, P-PLA, and PLA were implanted in rabbit tibial bone defects, G-PLA promoted bone maturation compared to P-PLA and pure PLA. Furthermore, G-PLA bonded directly to the host bone, whereas P-PLA bonded across the osteoid layers. Consequently, the bone-to-implant contact of G-PLA was 1.8- and 5.6-fold higher than those of P-PLA and PLA, respectively. Furthermore, the adhesive shear strength of G-PLA was 1.9- and 3.0-fold higher than those of P-PLA and PLA, respectively. Thus, G-PLA achieved earlier and stronger osseointegration than P-PLA or PLA. The findings of this study highlight the significance of the state of dispersion of OCs in implants as a novel strategy for material development.
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Affiliation(s)
- Cheng Zhang
- Department of Biomaterials Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Koichiro Hayashi
- Department of Biomaterials Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Kunio Ishikawa
- Department of Biomaterials Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Alagarsamy R, Lal B, Arangaraju R, Roychoudhury A, Srivastava RK, Barathi A. Endoscopic-assisted intraoral approach for mandibular condyle fracture management: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:537-553. [PMID: 37635009 DOI: 10.1016/j.oooo.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE Surgical innovation led to an endoscopic-assisted intraoral approach for managing condyle fractures. The purpose of this systematic review is to purview the role of the endoscope and determine the range of information, summarizing the evidence for the benefit of surgeons on an endoscopic-assisted intraoral approach. STUDY DESIGN A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases for studies mentioning the endoscopic intraoral approach for managing mandibular condylar fractures. Outcomes include the role of the endoscope, challenges, adjunct armamentarium, duration, and complications associated with the transoral and transbuccal approach for screw fixation. The meta-analysis was conducted with prevalence estimates and standardized means using STATA. RESULTS Thirty-nine studies were included. A 30° angulated, 4-mm-thick endoscope was the most commonly used endoscope. Two mini plates were most commonly used for fixation. Facial nerve weakness was higher in the transbuccal approach (1.24%) than in the transoral approach (0.8%). Pooled analysis (6 studies) showed that the duration of the surgical procedure was less in the transoral approach compared with the transbuccal approach for screw fixation. The bailout was 1.49%. CONCLUSIONS The endoscopic-assisted intraoral approach is reliable for condylar fracture management. The transoral and transbuccal approaches can be used for screw fixation with comparable outcomes.
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Affiliation(s)
- Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
| | - Babu Lal
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Ramya Arangaraju
- Department of Oral and Maxillofacial Surgery, GDC Kottayam, Kerala, India
| | - Ajoy Roychoudhury
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Rakesh Kumar Srivastava
- Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
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Gareb B, van Bakelen NB, Driessen L, Buma P, Kuipers J, Grijpma DW, Vissink A, Bos RR, van Minnen B. Biocompatibility and degradation comparisons of four biodegradable copolymeric osteosynthesis systems used in maxillofacial surgery: A goat model with four years follow-up. Bioact Mater 2022; 17:439-456. [PMID: 35386449 PMCID: PMC8961280 DOI: 10.1016/j.bioactmat.2022.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/10/2021] [Accepted: 01/08/2022] [Indexed: 01/15/2023] Open
Abstract
Applying biodegradable osteosyntheses avoids the disadvantages of titanium osteosyntheses. However, foreign-body reactions remain a major concern and evidence of complete resorption is lacking. This study compared the physico-chemical properties, histological response and radiographs of four copolymeric biodegradable osteosynthesis systems in a goat model with 48-months follow-up. The systems were implanted subperiosteally in both tibia and radius of 12 Dutch White goats. The BioSorb FX [poly(70LLA-co-30DLLA)], Inion CPS [poly([70–78.5]LLA-co-[16–24]DLLA-co-4TMC)], SonicWeld Rx [poly(DLLA)], LactoSorb [poly(82LLA-co-18GA)] systems and a negative control were randomly implanted in each extremity. Samples were assessed at 6-, 12-, 18-, 24-, 36-, and 48-month follow-up. Surface topography was performed using scanning electron microscopy (SEM). Differential scanning calorimetry and gel permeation chromatography were performed on initial and explanted samples. Histological sections were systematically assessed by two blinded researchers using (polarized) light microscopy, SEM and energy-dispersive X-ray analysis. The SonicWeld Rx system was amorphous while the others were semi-crystalline. Foreign-body reactions were not observed during the complete follow-up. The SonicWeld Rx and LactoSorb systems reached bone percentages of negative controls after 18 months while the BioSorb Fx and Inion CPS systems reached these levels after 36 months. The SonicWeld Rx system showed the most predictable degradation profile. All the biodegradable systems were safe to use and well-tolerated (i.e., complete implant replacement by bone, no clinical or histological foreign body reactions, no [sterile] abscess formation, no re-interventions needed), but nanoscale residual polymeric fragments were observed at every system's assessment. Foreign-body reactions are a major concern of biodegradable osteosyntheses. Amorphous poly(DLLA) showed the most predictable degradation profile. Nanoscale residual polymeric fragments could still be observed after 4 years.
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Whulanza Y, Azadi A, Supriadi S, Rahman S, Chalid M, Irsyad M, Nadhif M, Kreshanti P. Tailoring mechanical properties and degradation rate of maxillofacial implant based on sago starch/polylactid acid blend. Heliyon 2022; 8:e08600. [PMID: 35028440 PMCID: PMC8741438 DOI: 10.1016/j.heliyon.2021.e08600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/21/2021] [Accepted: 12/09/2021] [Indexed: 12/04/2022] Open
Abstract
A polymeric bone implants have a distinctive advantage compared to metal implants due to their degradability in the local bone host. The usage of degradable implant prevents the need for an implant removal surgery especially if they fixated in challenging position such as maxillofacial area. Additionally, this fixation system has been widely applied in fixing maxillofacial fracture in child patients. An ideal degradable implant has a considerable mass degradation rate that proved structural integrity to the healing bone. At this moment, poly(lactic acid) (PLA) or poly(lactic-co-glycolic acid) (PLGA) are the most common materials used as degradable implant. This composition of materials has a degradation rate of more than a year. A long degradation rate increases the long-term biohazard risk for the bone host. Therefore, a faster degradation rate with adequate strength of implant is the focal point of this research. This study tailored the tunable degradability of starch with strength properties of PLA. Blending system of starch and PLA has been reported widely, but none of them were aimed to be utilized as medical implant. Here, various concentrations of sago starch/PLA and Polyethylene glycol (PEG) were composed to meet the requirement of maxillofacial miniplate implant. The implant was realized using an injection molding process to have a six-hole-miniplate with 1.2 mm thick and 34 mm length. The specimens were physiochemically characterized through X-ray diffraction, differential scanning calorimetry, thermogravimetric analysis, and Fourier Transform Infrared spectroscopy. It is found that the microstructure and chemical interactions of the starch/PLA/PEG polymers are correlated with the mechanical characteristics of the blends. Compared to a pure PLA miniplate, the sago starch/PLA/PEG blend shows a 60-80% lower tensile strength and stiffness. However, the flexural strength and elongation break are improved. A degradation study was conducted to observe the mass degradation rate of miniplate for 10 weeks duration. It is found that a maximum concentration of 20% sago starch and 10% of PEG in the PLA blending has promising properties as desired. The blends showed a 100-150% higher degradability rate compared to the pure PLA or a commercial miniplate. The numerical simulation was conducted and confirmed that the miniplate in the mandibular area were shown to be endurable with standard applied loading. The mechanical properties resulted from the experimental work was applied in the Finite Element Analysis to find that our miniplate were in acceptable level. Lastly, the in-vitro test showed that implants are safe to human cell with viability more than 80%. These findings shall support the use of this miniplate in rehabilitating mandibular fractures with faster degradation with acceptance level of mechanical characteristic specifically in case of 4-6 weeks bone union.
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Affiliation(s)
- Y. Whulanza
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
| | - A. Azadi
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Indonesian Agency for Agricultural Research and Development, Indonesia
| | - S. Supriadi
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
| | - S.F. Rahman
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
- Department of Electrical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
| | - M. Chalid
- Department of Metallurgical and Material Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
| | - M. Irsyad
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Medical Technology Cluster, Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
| | - M.H. Nadhif
- Medical Technology Cluster, Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
- Department of Medical Physics, Faculty of Medicine, Universitas Indonesia, Indonesia
| | - P. Kreshanti
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
- Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Indonesia
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Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis. J Clin Med 2021; 11:jcm11010207. [PMID: 35011948 PMCID: PMC8745675 DOI: 10.3390/jcm11010207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/25/2021] [Indexed: 01/11/2023] Open
Abstract
This study aimed to evaluate the reliability of a trapezium plate for open reduction and internal fixation (ORIF) of mandibular subcondylar fractures with the simultaneous use of an endoscope. We selected and retrospectively studied 18 patients (12 males and 6 females) with unilateral mandibular subcondylar fractures who visited the Wonju Severance Christian Hospital. The mean age of the patients was 43.43 ± 15.76 years. Patients underwent ORIF with trapezium miniplate application through an intraoral incision under general anesthesia. The clinical and radiographic findings of the fractured side were compared with those of the non-operated side at 6 months follow-up. All occlusions became stable, and transient functional disturbances disappeared within 6 months of periodic follow-up. Functional mandibular movement recovered within the normal range, with an average mouth opening of 41.5 mm, protrusion of 7.5 mm, and lateral excursion of 7 mm at 6 months. Radiographic controls and statistical analysis confirmed a decent anatomical reduction in all 18 cases. In conclusion, the use of a trapezium miniplate with endoscope-assisted ORIF in mandibular subcondylar fractures can be useful for fixation and functional recovery.
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Ngo HX, Bai Y, Sha J, Ishizuka S, Toda E, Osako R, Kato A, Morioka R, Ramanathan M, Tatsumi H, Okui T, Kanno T. A Narrative Review of u-HA/PLLA, a Bioactive Resorbable Reconstruction Material: Applications in Oral and Maxillofacial Surgery. MATERIALS (BASEL, SWITZERLAND) 2021; 15:150. [PMID: 35009297 PMCID: PMC8746248 DOI: 10.3390/ma15010150] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022]
Abstract
The advent of bioresorbable materials to overcome limitations and replace traditional bone-reconstruction titanium-plate systems for bone fixation, thus achieving greater efficiency and safety in medical and dental applications, has ushered in a new era in biomaterial development. Because of its bioactive osteoconductive ability and biocompatibility, the forged composite of uncalcined/unsintered hydroxyapatite and poly L-lactic acid (u-HA/PLLA) has attracted considerable interest from researchers in bone tissue engineering, as well as from clinicians, particularly for applications in maxillofacial reconstructive surgery. Thus, various in vitro studies, in vivo studies, and clinical trials have been conducted to investigate the feasibility and weaknesses of this biomaterial in oral and maxillofacial surgery. Various technical improvements have been proposed to optimize its advantages and limit its disadvantages. This narrative review presents an up-to-date, comprehensive review of u-HA/PLLA, a bioactive osteoconductive and bioresorbable bone-reconstruction and -fixation material, in the context of oral and maxillofacial surgery, notably maxillofacial trauma, orthognathic surgery, and maxillofacial reconstruction. It simultaneously introduces new trends in the development of bioresorbable materials that could used in this field. Various studies have shown the superiority of u-HA/PLLA, a third-generation bioresorbable biomaterial with high mechanical strength, biocompatibility, and bioactive osteoconductivity, compared to other bioresorbable materials. Future developments may focus on controlling its bioactivity and biodegradation rate and enhancing its mechanical strength.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Shimane, Japan; (H.X.N.); (Y.B.); (J.S.); (S.I.); (E.T.); (R.O.); (A.K.); (R.M.); (M.R.); (H.T.); (T.O.)
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Gareb B, van Bakelen NB, Dijkstra PU, Vissink A, Bos RRM, van Minnen B. Efficacy and morbidity of biodegradable versus titanium osteosyntheses in orthognathic surgery: A systematic review with meta-analysis and trial sequential analysis. Eur J Oral Sci 2021; 129:e12800. [PMID: 34131965 PMCID: PMC8596673 DOI: 10.1111/eos.12800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
Titanium osteosynthesis is currently the gold standard in orthognathic surgery. Use of biodegradable osteosyntheses avoids removal of plates/screws in a second operation. This systematic review aimed to assess the efficacy and morbidity of biodegradable vs. titanium osteosyntheses in orthognathic surgery (PROSPERO CRD42018086477). Patients with syndromic disorder(s) and/or cleft lip/palate were excluded. Randomised, prospective and retrospective controlled studies were searched for in nine databases (February 2021). The time periods perioperative, short‐term, intermediate, long‐term, and overall follow‐up were studied. Meta‐analyses were performed using random‐effects models. A total of 9073 records was assessed, of which 33 were included, comprising 2551 patients. Seven RCTs had ‘some concerns’ while another seven RCTs had ‘high’ risk of bias (Cochrane‐RoB2). No differences in malunion (qualitative analyses), mobility of bone segments [RR 1.37 (0.47; 3.99)], and malocclusion [RR 0.93 (0.39; 2.26)] were found. The operative time was longer in the biodegradable group [SMD 0.50 (0.09; 0.91)]. Symptomatic plate/screw removal was comparable among both groups [RR 1.29 (0.68; 2.44)]. Skeletal stability was similar in most types of surgery. Biodegradable osteosyntheses is a valid alternative to titanium osteosyntheses for orthognathic surgery, but with longer operation times. Since the quality of evidence varied from very low to moderate, high‐quality research is necessary to elucidate the potential of biodegradable osteosyntheses.
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Affiliation(s)
- Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Nico B van Bakelen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Pieter U Dijkstra
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ruud R M Bos
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Baucke van Minnen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Ramos A, Semedo T, Mesnard M. Study of fixation of a mandibular plate for favourable fractures of the mandibular angle: numerical predictions. Br J Oral Maxillofac Surg 2020; 58:652-658. [DOI: 10.1016/j.bjoms.2020.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
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Gareb B, van Bakelen N, Dijkstra P, Vissink A, Bos R, van Minnen B. Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis. Int J Oral Maxillofac Surg 2020; 49:914-931. [DOI: 10.1016/j.ijom.2019.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/02/2019] [Accepted: 11/20/2019] [Indexed: 01/18/2023]
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Park B, Jung BT, Kim WH, Lee JH, Kim B, Lee JH. The Stability of Hydroxyapatite/Poly-L-Lactide Fixation for Unilateral Angle Fracture of the Mandible Assessed Using a Finite Element Analysis Model. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E228. [PMID: 31947998 PMCID: PMC6981669 DOI: 10.3390/ma13010228] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 11/18/2022]
Abstract
Recently, a hydroxyapatite particle/poly-L-lactide (HA-PLLA) composite device was introduced as an alternative to previous fixation systems. In this study, we used finite element analysis to simulate peak von Mises stress (PVMS) and deformation of bone plates and screws with the following four materials-Ti, Mg alloy, PLLA, and HA-PLLA-at a unilateral mandibular fracture. A three-dimensional virtual mandibular model was constructed, and the fracture surface was designed to run from the left mandibular angle. Masticatory loading was applied on the right first molars. Stress was concentrated at the upper part and the neck of the screw. The largest PVMS was observed for Ti; that was followed by Mg alloy, HA-PLLA, and PLLA. The largest deformation was observed for PLLA; next was HA-PLLA, then Mg alloy, and finally Ti. We could rank relative superiority in terms of mechanical properties. The HA-PLLA screw and mini-plate deformed less than 0.15 mm until 300 N. Thus, we can expect good bone healing with usual masticatory loading six weeks postoperatively. HA-PLLA is more frequently indicated clinically than PLLA owing to less deformation. If the quality of HA-PLLA fixation is improved, it could be widely utilized in facial bone trauma or craniofacial surgery.
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Affiliation(s)
- Byungho Park
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ulsan, Asan Medical Center, Seoul 05505, Korea;
| | | | - Won Hyeon Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (W.H.K.); (J.-H.L.)
| | - Jong-Ho Lee
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (W.H.K.); (J.-H.L.)
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea
| | - Bongju Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea; (W.H.K.); (J.-H.L.)
| | - Jee-Ho Lee
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ulsan, Asan Medical Center, Seoul 05505, Korea;
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Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2384. [PMID: 31592391 PMCID: PMC6756660 DOI: 10.1097/gox.0000000000002384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/04/2022]
Abstract
Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysis is to shed light on overall outcomes for resorbable implants and to compare these results to those for metallic counterparts.
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