Biodegradable polylactide plates and screws in orthognathic surgery: technical note

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Polymer Chemistry

Background:

• Orthognathic surgery traditionally uses metallic plates and screws for bone fragment fixation.
• While titanium plates are intended for long-term implantation, concerns regarding corrosion and particle release necessitate their removal.
• Secondary surgeries for device removal often require general anesthesia, increasing patient risk and healthcare costs.

Observation:

• Self-reinforced poly (L-lactide) (PLLA) and poly (L/D-lactide) stereocopolymers exhibit sufficient strength for fracture fixation.
• These bioresorbable plates can be manipulated at room temperature, facilitating surgical application.
• A novel surgical technique utilizing these materials for bimaxillary surgery and genioplasty without rigid maxillomandibular fixation was employed.

Findings:

• The use of bioresorbable plates in orthognathic surgery avoids the complications associated with metallic implants, such as corrosion and particle dissemination.
• The reported case demonstrates successful application of these materials in complex craniofacial reconstruction.
• Absence of postoperative rigid maxillomandibular fixation suggests potential for improved patient comfort and reduced treatment duration.

Implications:

• Bioresorbable fixation devices represent a significant advancement in orthognathic surgery, potentially reducing the need for revision surgeries.
• This technology may enhance patient outcomes by minimizing inflammatory responses and long-term foreign body reactions.
• Further research into the long-term stability and degradation profiles of these materials is warranted for broader clinical adoption.