Segmental stability in orthognathic surgery: hydroxyapatite/Poly-l-lactide osteoconductive composite versus titanium...

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Orthodontics

Background:

• Orthognathic surgery relies on stable osteosynthesis materials for predictable outcomes.
• Titanium miniplates are a common standard, but bioabsorbable alternatives are sought for reduced long-term complications.
• Hydroxyapatite's osteoconductive properties make it a promising additive to bioabsorbable polymers like Poly L-lactide (PLLA).

Purpose of the Study:

• To evaluate the segmental retention and outcome stability of a novel unsintered hydroxyapatite-Poly L-lactide (F-u-HA/PLLA) composite osteosynthesis material.
• To compare the performance of F-u-HA/PLLA osteosyntheses against traditional titanium miniplates in orthognathic surgery.
• To assess the long-term stability and relapse rates associated with F-u-HA/PLLA in complex maxillofacial reconstructions.

Main Methods:

• A comparative study involving 50 patients undergoing orthognathic surgery.
• 25 patients were treated with F-u-HA/PLLA bioabsorbable osteosyntheses, and 25 with titanium miniplates.
• Radiographic cephalometric analysis was used to assess preoperative, postoperative, and follow-up stability (average 22-24 months).

Main Results:

• No significant differences in absolute operative movements were observed between the F-u-HA/PLLA and titanium groups.
• Relapse rates were nonsignificant between the two groups.
• Titanium miniplates showed a trend towards greater vertical relapse in maxillary impaction cases compared to F-u-HA/PLLA.

Conclusions:

• F-u-HA/PLLA composite osteosyntheses demonstrate comparable stability and segmental retention to titanium miniplates in orthognathic surgery.
• The F-u-HA/PLLA material shows promise as a viable bioabsorbable alternative to titanium for complex maxillofacial procedures.
• This osteoconductive composite offers enhanced stability compared to other bioabsorbable polymers previously studied.