title: A prospective trial of poly-L-lactic/polyglycolic acid co-polymer plates and screws for internal fixation of mandibular fractures.
abstract: The aim of this study was to test the performance of poly-L-lactic/polyglycolic acid (PLLA/PGA) co-polymer plates and screws in the fixation of mandibular fractures. Following clinical and radiographic examination, internal fixation was achieved with PLLA/PGA co-polymer plates and screws in 31 patients. Elastic maxillomandibular fixation was maintained for 4 weeks and a blenderized diet for 6 weeks. Patients were followed up at 1 week, 6 weeks, and 3, 6 and 12 months post surgery, and evaluated clinically for swelling, pain, mucosal discoloration and occlusal relation. Segment stability, fracture healing and screw-hole ossification were assessed radiographically. Of the 29 patients who completed the trial, 20 had an uncomplicated postoperative period, resulting in complete bone union. Radiographic evidence of screw-hole ossification was noted in several patients, with considerable site-dependent rate variation. Nine patients developed complications ranging from minor dehiscence (4 patients) to frank sepsis requiring plate removal (5 patients), resulting in a 22.5% complication rate. There were no cases of non-union at the end of the fixation period. The reported complication rate following titanium internal fixation of mandibular fractures is 13.7%-43%. PLLA/PGA co-polymer plate and screw fixation of mandibular fractures, although technically more challenging and costly, is a viable alternative to traditional metal devices in selected patients.
authors.affiliation: Division of Maxillofacial and Oral Surgery, Chris Hani Baragawanth Hospital and University of the Witwatersrand, Johannesburg, South Africa. ferretti@mweb.co.za
authors.forename: C
authors.initials: C
authors.lastname: Ferretti
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials / Q000737:chemistry; D001860:Bone Plates; D001863:Bone Screws; D020878:Device Removal; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D019248:Jaw Fixation Techniques; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D009059:Mouth Diseases / Q000209:etiology; D010012:Osteogenesis / Q000502:physiology; D010149:Postoperative Pain / Q000209:etiology; D011100:Polyglycolic Acid / Q000737:chemistry; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011183:Postoperative Complications; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology
chemical_list: D001672:Biocompatible Materials; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid