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Resorbable PLLA-PGA screw fixation of mandibular sagittal split osteotomies
R C Edwards1, K D Kiely, B L Eppley
1Department of Oral and Maxillofacial Surgery, 1st Medical Group, Langley Air Force Base, VA, USA.
The Journal of Craniofacial Surgery
|October 26, 1999
Summary
Resorbable copolymeric screws (PLLA-PGA) offer effective fixation for mandibular sagittal split osteotomies, comparable to traditional metallic screws. These screws provide excellent stability without the need for maxillomandibular fixation, demonstrating promising clinical outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials Science
- Orthognathic Surgery
Background:
- Mandibular sagittal split osteotomies are common in orthognathic surgery.
- Traditional fixation methods often involve metallic screws, which may require removal.
- The development of resorbable fixation materials offers potential advantages in bone healing and patient comfort.
Purpose of the Study:
- To evaluate the intraoperative placement and clinical effectiveness of resorbable copolymeric screws for mandibular sagittal split ramus osteotomies.
- To compare the outcomes of resorbable screw fixation with conventional metallic fixation.
Main Methods:
- A prospective study involving 37 patients undergoing bilateral sagittal split osteotomies.
- Fixation was achieved using 2.5-mm copolymeric poly-L-lactic-polyglycolic (PLLA-PGA) screws.
- No postoperative maxillomandibular fixation was applied.
Main Results:
- Intraoperative screw placement was uncomplicated, with no stripping.
- Immediate postoperative stability was excellent, with no relapse observed in any patient.
- Radiographic evidence of screw holes persisted for over 1 year.
Conclusions:
- Copolymer poly-L-lactic-polyglycolic (PLLA-PGA) resorbable screws provide effective fixation for mandibular ramus osteotomies.
- Clinical results are comparable to those achieved with metallic screw fixation.
- These resorbable screws offer a viable alternative for stable fixation in orthognathic surgery.