Resorbable versus titanium plates for facial fractures.

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Trauma Management

Background:

• Rigid internal fixation using titanium plates and screws is standard for facial fractures.
• Bioresorbable fixation systems offer potential advantages, including eliminating the need for a second surgery.
• Concerns exist regarding bioresorbable systems' stability, degradation time, and foreign body reactions.

Purpose of the Study:

• To compare the effectiveness of bioresorbable fixation systems versus titanium systems in managing facial fractures.

Main Methods:

• A systematic literature search was conducted across multiple databases (Cochrane, MEDLINE, EMBASE, clinicaltrials.gov) up to August 20, 2008.
• Inclusion criteria focused on randomized controlled trials comparing resorbable and titanium fixation for facial fractures.
• Data analysis planned for random-effects models, with mean differences and risk ratios for continuous and dichotomous outcomes, respectively.

Main Results:

• The search identified 53 potentially eligible studies, but none met the inclusion criteria and were excluded.
• One study is awaiting classification due to an inability to obtain the full text.
• Three ongoing trials were identified; two were stopped early, one due to excess complications in the bioresorbable group.

Conclusions:

• No published randomized controlled trials were found, indicating insufficient evidence to compare bioresorbable and titanium fixation systems for facial fractures.
• Preliminary findings from aborted trials suggest bioresorbable plates may not be as effective as titanium plates.
• Future ongoing clinical trials are expected to provide reliable evidence for clinical decision-making.