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Biomechanical Performance of Biodegradable Screw Fixation in Mandibular Distraction Osteogenesis.

Joseph Mark Firriolo1, Yunfeng Xue1, Jonathan S Weyerbacher1

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Bioabsorbable poly-L-lactide (PLLA) screws simplify removal after mandibular distraction surgery. These PLLA screws can withstand forces double those typically encountered, offering a viable alternative to titanium screws for internal distraction devices.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Craniofacial Surgery

Background:

  • Internal distraction devices are crucial for treating congenital micrognathia.
  • Screw removal after distraction can be complex, necessitating significant surgical intervention.
  • Bioabsorbable poly-L-lactide (PLLA) screws offer potential for easier removal compared to titanium screws.

Purpose of the Study:

  • To evaluate the mechanical strength of bioabsorbable PLLA screws under simulated mandibular distraction forces.
  • To compare the performance of PLLA screws against traditional titanium screws in fixation of mandibular distractors.

Main Methods:

  • Canine cadaveric mandibles were used, with distractors fixed using either titanium or PLLA screws.
  • Distractors were subjected to simulated distraction distances (15 and 30 mm) and a pre-set compression force of 80 N.
  • Load-to-failure compression testing was performed on the PLLA screw group to determine mechanical failure points.

Main Results:

  • Both titanium and PLLA screws withstood the 80 N compression force without mechanical failure.
  • PLLA screws failed at an average load of 172.8 N, more than double the maximal in vivo distraction force (69.4 N).
  • Failures in the PLLA group were attributed to screw breakage or loosening.

Conclusions:

  • Bioabsorbable PLLA screws demonstrate sufficient mechanical integrity to support mandibular distraction forces.
  • PLLA screws present a potentially advantageous alternative to titanium screws for internal mandibular distraction device fixation, simplifying removal.
  • Further clinical evaluation is warranted to confirm the efficacy and safety of PLLA screws in patient populations.