Bioabsorbable self-reinforced plates and screws in craniomaxillofacial surgery

Bioabsorbable fixation devices have been used in craniomaxillofacial (CMF) surgery since the early 70's. In our departments the experimental use started in the 80's with self-reinforced (SR) polylactide devices. The first clinical operations were carried out in 1991. Since that time, we have used different types of self-reinforced bioabsorbable devices in the fixation of several hundreds of osteotomies and fractures. Patients' acceptance has been generally excellent and very few complications occurred during this follow-up of over 10 years. The complications have been minor and have not affected the end results of the operations. In only one oncologic patient, the devices needed to be removed and replaced with a rigid reconstruction plate. The minor complications consisted mainly of a few infections, dehiscence of the wound and plate exposure together with granulation tissue in the operation field. No implant-specific complications were recorded. However, there is a learning curve for the surgeon, as there is with all new methods introduced. Based on our experience, self-reinforced bioabsorbable devices are safe to be used in several indications in the craniomaxillofacial skeleton, also in load-shearing situations.