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Complications of a poly-l-lactic acid and polyglycolic acid osteosynthesis device for internal fixation in maxillofacial surgery

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Abstract

The purpose of this study was to retrospectively evaluate and examine the incidence of complications using poly-l-lactic acid and polyglycolic acid (PLLA/PGA) copolymer plate system in maxillofacial osteosynthesis. The retrospective study included 87 patients (50 men, 37 women), who needed maxillofacial surgery. We examined the proportion of complications and their factors from clinical data. A comparison was also made for plate decomposition using the molecular weight of the plate without plate exposure and complications. Osteosynthesis sites healed in all patients. Ten cases (11.5%) showed plate exposure-related complications, with all occurring at intraoral surgical sites. There was no significant difference in molecular weight changes of plates in resorbable process. Statistical analysis of study variables between patients with and without exposed plates showed that the plate thickness was significantly associated with the risk of exposed plates (p < 0.05). The commercially available PLLA/PGA device could be a useful rapid resorbable material for maxillofacial osteosynthesis. When thick plates are used on the intraoral site, it may be necessary to pay attention to the complication of plate exposure. Even if exposure-related complications have occurred, resorption and degradation of this material proceeds, suggesting the ease of appropriate risk management.

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References

  1. Suuronen R. Biodegradable fracture-fixation devices in maxillofacial surgery. Int J Oral Maxillofac Surg. 1993;22:50–7.

    Article  Google Scholar 

  2. Ferretti C. A prospective trial of poly-l-lactic/polyglycolic acid co-polymer plates and screws for internal fixation of mandibular fractures. Int J Oral Maxillofac Surg. 2008;37:242–8.

    Article  Google Scholar 

  3. Buijs GJ, van Bakelen NB, Jansma J, de Visscher JG, Hoppenreijs TJ, Bergsma JE, Stegenga B, Bos RR. A randomized clinical trial of biodegradable and titanium fixation systems in maxillofacial surgery. J Dent Res. 2012;91:299–304.

    Article  Google Scholar 

  4. Sukegawa S, Kanno T, Kawai H, Shibata A, Sukegawa-Takahashi Y, Furuki Y. Postoperative infection caused by a resorbable plate used to treat a zygomatic fracture. Clin Surg. 2016;1:1–3.

    Google Scholar 

  5. Eppley BL, Morales L, Wood R, Pensler J, Goldstein J, Havlik RJ, Habal M, Losken A, Williams JK, Burstein F, Rozzelle AA, Sadove AM. Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1883 patients. Plast Reconstr Surg. 2004;114:850–6.

    Article  Google Scholar 

  6. Kang IG, Jung JH, Kim ST, Choi JY, Sykes JM. Comparison of titanium and biodegradable plates for treating midfacial fractures. J Oral Maxillofac Surg. 2014;72:762.

    PubMed  Google Scholar 

  7. Sukegawa S, Kanno T, Nagano D, Shibata A, Sukegawa-Takahashi Y, Furuki Y. The clinical feasibility of newly developed thin flat-type bioresorbable osteosynthesis devices for the internal fixation of zygomatic fractures. J Craniofac Surg. 2016;27:2124–9.

    Article  Google Scholar 

  8. Sukegawa S, Kanno T, Katase N, Shibata A, Takahashi Y, Furuki Y. Clinical evaluation of an unsintered hydroxyapatite/poly-l-lactide osteoconductive composite device for the internal fixation of maxillofacial fractures. J Craniofac Surg. 2016;27:1391–7.

    Article  Google Scholar 

  9. Wittwer G, Adeyemo WL, Yerit K, Voracek M, Turhani D, Watzinger F, Enislidis G. Complications after zygoma fracture fixation: is there a difference between biodegradable materials and how do they compare with titanium osteosynthesis? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:419–25.

    Article  Google Scholar 

  10. Sivolella S, Brunello G, Berengo M, De Biagi M, Bacci C. Rehabilitation with implants after bone lid surgery in the posterior mandible. J Oral Maxillofac Surg. 2015;73:1485–92.

    Article  Google Scholar 

  11. Quereshy FA, Dhaliwal HS, El SA, Horan MP, Dhaliwal SS. Resorbable screw fixation for cortical onlay bone grafting: a pilot study with preliminary results. J Oral Maxillofac Surg. 2010;68:2497–502.

    Article  Google Scholar 

  12. Pietrzak WS, Caminear DS, Perns SV. Mechanical characteristics of an absorbable copolymer internal fixation pin. J Foot Ankle Surg. 2002;41:379–88.

    Article  Google Scholar 

  13. Sukegawa S, Kanno T, Shibata A, Takahashi Y, Furuki Y. Use of templates and self-tapping metal screws for temporary fixation of a resorbable plate system. Ann Maxillofac Surg. 2015;5:231–3.

    Article  Google Scholar 

  14. Eppley BL, Sadove AM. A comparison of resorbable and metallic fixation in healing of calvarial bone grafts. Plast Reconstr Surg. 1995;96:316–22.

    Article  Google Scholar 

  15. Sukegawa S, Kanno T, Kawai H, Shibata A, Takahashi Y, Nagatsuka H, Furuki Y. Long-term bioresorption of bone fixation devices made from composites of unsintered hydroxyapatite particles and poly-l-lactide. J Hard Tissue Biol. 2015;24:219–24.

    Article  Google Scholar 

  16. Kubota Y, Kuroki T, Akita S, Koizumi T, Hasegawa M, Rikihisa N, Mitsukawa N, Satoh K. Association between plate location and plate removal following facial fracture repair. J Plast Reconstr Aesthet Surg. 2012;65:372–8.

    Article  Google Scholar 

  17. Bell RB, Kindsfater CS. The use of biodegradable plates and screws to stabilize facial fractures. J Oral Maxillofac Surg. 2006;64:31–9.

    PubMed  Google Scholar 

  18. van der Elst M, Klein CP, de Blieck-Hogervorst JM, Patka P, Haarman HJ. Bone tissue response to biodegradable polymers used for intra medullary fracture fixation: a long-term in vivo study in sheep femora. Biomaterials. 1999;20:121–8.

    Article  Google Scholar 

  19. Pietrzak WS, Sarver DR, Verstynen ML. “Bioabsorbable polymer science for the practicing surgeon. J Craniofac Surg. 1997;8:87–91.

    Article  Google Scholar 

  20. Stanton DC, Liu F, Yu JW, Mistretta MC. Use of bioresorbable plating systems in paediatric mandible fractures. J Craniomaxillofac Surg. 2014;42:1305–9.

    Article  Google Scholar 

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Funding

The authors received no support from any grant.

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Authors and Affiliations

  1. Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-cho, Takamatsu, 760-8557, Kagawa, Japan

    Shintaro Sukegawa, Kenichi Matsumoto, Yuka Sukegawa-Takahashi, Masanori Masui & Yoshihiko Furuki

  2. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Shimane University, Matsue, Shimane, Japan

    Takahiro Kanno

Authors
  1. Shintaro Sukegawa
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  2. Takahiro Kanno
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  3. Kenichi Matsumoto
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  4. Yuka Sukegawa-Takahashi
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  5. Masanori Masui
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  6. Yoshihiko Furuki
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Contributions

SS participated in the design of the study, acquisition of data, and drafted the manuscript. TK performed and coordinated the study and contributed to the drafting of the manuscript. KM, YT, and MM collected the data and compiled all medical records. YF conceived the study and participated in its design. All authors approved the final version of the manuscript prior to submission.

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Correspondence to Shintaro Sukegawa.

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Sukegawa, S., Kanno, T., Matsumoto, K. et al. Complications of a poly-l-lactic acid and polyglycolic acid osteosynthesis device for internal fixation in maxillofacial surgery. Odontology 106, 360–368 (2018). https://doi.org/10.1007/s10266-018-0345-6

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  • DOI: https://doi.org/10.1007/s10266-018-0345-6

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