The use of bioabsorbable osteofixation devices in craniomaxillofacial surgery

Because of problems associated with the conventional osteofixation devices used in craniomaxillofacial surgery, bioabsorbable devices have presented an appealing alternative. Devices made of the polymers polyglycolide (PGA) and polylactide (PLA) and their copolymers (PLGA and PLDLA) are currently the most commonly used. Strong implants can be manufactured from these polymers with a self-reinforcing technique and used in the treatment of fractures and osteotomies. Self-reinforced devices have been studied for nearly 2 decades by our multidisciplinary research group for internal fixation of the bone in both experimental and clinical settings. In craniomaxillofacial fractures and osteotomies they have been used for as long as 10 years with no significant clinical problems. Because of more favored degradation characteristics, currently the copolymer devices (PLDLA and PLGA) represent the advancing front in the application of absorbable devices in craniomaxillofacial surgery. By using bioabsorbable devices, several problems associated with conventional biostable devices can be avoided, especially in children. New techniques that are not possible with biostable devices can be developed by using bioabsorbable devices, too. Our experience with and research on self-reinforced devices are shared here.