Use of resorbable implants for mandibular fixation: a systematic review

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Titanium plating is the standard for mandibular fracture and osteotomy treatment.
• Resorbable implants are used for craniofacial fractures, but their mandibular application lacks comprehensive review.
• This study addresses the gap in understanding resorbable implant use in the mandible.

Purpose of the Study:

• To systematically review the existing literature on resorbable implants for mandibular fixation.
• To analyze complication rates and outcomes associated with resorbable plates and screws versus screws alone.
• To identify areas for future research, particularly the need for randomized controlled trials.

Main Methods:

• Systematic literature search of MEDLINE/PubMed and Cochrane Database for resorbable mandibular fixation studies.
• Inclusion/exclusion criteria applied by two independent reviewers.
• Analysis of 22 articles detailing 19 studies, including one randomized controlled trial, involving 326 patients (plates/screws) and 112 patients (screws alone).

Main Results:

• Various resorbable materials (e.g., PLLA, PLLA 70/PDLLA 30) from multiple manufacturers were used.
• Plate group: 14-15 infections, 2 foreign body reactions, 7 malocclusions, 8 malunions, 8-10 premature removals.
• Screws-only group: 1 foreign body reaction, 2 malocclusions.

Conclusions:

• Resorbable implants show potential for mandibular fixation, with differing complication profiles between plates and screws alone.
• Patient selection criteria significantly influence reported outcomes.
• Further high-quality randomized controlled trials are essential to establish optimal use and efficacy.