title: Fixation of Le Fort I osteotomies with poly-DL-lactic acid mesh and ultrasonic welding--a new technique.
abstract: OBJECTIVE
  This report describes a technique for use of resorbable mesh (Resorb-X) and an ultrasonic sonotrode unit (SonicWeld Rx) to bond a pin (SonicPin Rx) to the mesh and underlying bone for Le Fort I osteotomy fixation, precluding the need to tap, shortening the time needed for fixation, and eliminating many disadvantages of titanium. In total, 659 cases have been performed from October 2005 through December 2010. This study examined the first 103 consecutive Le Fort osteotomies performed with this resorbable system and thus those with the longest follow-up.
  
  
  METHODS
  One hundred three consecutive patients who had completed growth and presurgical orthodontics were operated on using the Resorb-X plating system and SonicWeld Rx. Intraoperative adverse events were monitored and a minimum 12-month postoperative follow-up for complications was completed.
  
  
  RESULTS
  One patient (0.9%) had maxillary mobility at initial postoperative evaluation that resolved without malocclusion. Two patients (1.9%) exhibited signs of residual soreness and swelling in the maxilla, attributed to sterile abscess formation. At last follow-up, all patients demonstrated a clinically stable maxilla with correction of their malocclusion.
  
  
  CONCLUSIONS
  Use of ultrasonic-aided pins in fixation of resorbable mesh plates, in Le Fort I osteotomies, is a viable technique and superior resorbable plating system because it is easy to use, results in adequate fixation strength, and shortens time of application by eliminating the need for tapping. In addition, this resorbable system eliminates many disadvantages associated with using all-titanium fixation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christiana Care Health System, Wilmington, DE, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Meara
authors.forename: Michael R
authors.initials: MR
authors.lastname: Knoll
authors.forename: Jon D
authors.initials: JD
authors.lastname: Holmes
authors.forename: D Mark
authors.initials: DM
authors.lastname: Clark
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry*; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019344:Lactic Acid / Q000737:chemistry*; D008297:Male; D008310:Malocclusion / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation; D009984:Orthopedic Fixation Devices; D019340:Osteotomy, Le Fort / Q000295:instrumentation*; D011091:Polyesters; D011108:Polymers / Q000737:chemistry*; D011183:Postoperative Complications; D013526:Surgical Mesh; D014025:Titanium / Q000737:chemistry; D014465:Ultrasonics; D014896:Welding / Q000379:methods*; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D014025:Titanium