Comparison of functional outcomes and patient-reported satisfaction between titanium and absorbable plates and screws for fixation of mandibular fractures: A one-year prospective study.
OBJECTIVE
The aim of this study is to compare the 1-year functional outcomes and patient-reported satisfaction in treating mandibular fractures between resorbable and titanium fixation devices.


METHODS
A 1-year prospective study was conducted; 41 consecutive patients presenting with mandibular fractures were included. A resorbable system was used in 21 patients, while in 20 patients a titanium fixation device was used. Functional outcome was evaluated objectively at several time points (2, 4 and 6 weeks, 3 and 6 months, and 1 year after surgery). Bite forces over molars and incisors, mouth opening distance, occlusal status, operation time, fee for implants, bone healing and plate-associated complications were evaluated. Functional and overall satisfaction was measured by patients themselves subjectively.


RESULTS
A statistical difference was found only in maximal mouth opening and molar bite force, both greater for the titanium group in the 2-week time point, achieving comparable measurements in subsequent ones. This coincides with the patient-reported statistically lower satisfaction rates. The cost of the resorbable device was nearly 3 times more expensive than the titanium devices.


CONCLUSIONS
Resorbable fixation can achieve stability of bone healing at 1 year postoperatively, with functional and satisfaction outcomes comparable to those associated with titanium hardware from the fourth week postoperatively, while yielding unique advantages.
Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Maria Belén
MB
Leno
Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Stanley Yung
SY
Liu
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Craniofacial Research Center, 222, Maijin Road, Keelung, Taiwan.
Chien-Tzung
CT
Chen
Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Trauma Plastic Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, 5, Fu-Shing Street, Kuei-Shan, Taoyuan, 333, Taiwan; College of Medicine, Chang Gung University, Kuei-shan, Taoyuan, Taiwan. Electronic address: lia01211@gmail.com.
Han-Tsung
HT
Liao
D020341:Absorbable Implants; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium
Biting forces; Mandibular fractures; Poly-L/DL-lactide; Resorbable fixation