Evaluación comparativa de sistemas de fijación reabsorbibles versus titanio en el manejo de fracturas mandibulares

Titanium plates have long been the gold standard in mandibular fracture fixation. However, concerns regarding palpability, imaging artifacts, and the need for hardware removal have prompted the development of resorbable fixation systems. Despite their increasing use, comparative data on their efficacy and safety remain limited.

This study aims to compare the clinical outcomes of resorbable and titanium fixation systems in the management of mandibular fractures.

A prospective, randomized clinical trial was conducted on 60 patients with isolated mandibular fractures. Thirty patients were treated with titanium miniplates and screws, while the remaining 30 received resorbable poly-L-lactic acid (PLLA) fixation. Patients were evaluated at 1 week, 1 month, and 3 months postoperatively for stability, infection, wound healing, and neurosensory deficits.

Both groups showed similar rates of fracture union at 3 months (titanium: 96.7%, resorbable: 93.3%; P = 0.56). The mean operative time was significantly higher in the resorbable group (92.4 ± 12.6 min) compared to the titanium group (76.8 ± 10.9 min; P < 0.001). Transient wound dehiscence occurred in two patients (6.7%) in the resorbable group and 1 (3.3%) in the titanium group. No significant differences were observed in infection rates (P = 0.65) or neurosensory complications (P = 0.78).

Resorbable fixation systems demonstrate comparable clinical outcomes to titanium in mandibular fracture management, albeit with a longer operative time. These systems may offer an alternative for patients desiring implant-free recovery, particularly in pediatric or aesthetically sensitive populations.