Document Detail


Resorbable versus titanium plates for orthognathic surgery.
MedLine Citation:
PMID:  17443617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recognition of some of the limitations of titanium plates and screws used for the fixation of bones has led to the development of plates manufactured from bioresorbable materials. Whilst resorbable plates appear to offer clinical advantages over metal plates in orthognathic surgery, concerns remain about the stability of fixation and the length of time required for their degradation and the possibility of foreign body reactions.
OBJECTIVES: To compare the effectiveness of bioresorbable fixation systems with titanium systems used during orthognathic surgery.
SEARCH STRATEGY: We searched the following databases: Cochrane Oral Health Group Trials Register (to 26th January 2006); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 4); MEDLINE (without filter) (from 1966 to 26th January 2006); and EMBASE (without filter) (from 1980 to 26th January 2006).
SELECTION CRITERIA: Randomised controlled trials comparing resorbable versus titanium fixation systems used for orthognathic surgery.
DATA COLLECTION AND ANALYSIS: Clinical heterogeneity between the included trials precluded pooling of data, and only a descriptive summary is presented.
MAIN RESULTS: This review included two trials, involving 103 participants, one compared titanium with resorbable plates and screws and the other titanium with resorbable screws, both provided very limited data for the primary outcomes of this review. All patients in one trial suffered mild to moderate postoperative discomfort with no statistically significant difference between the two plating groups at different follow-up times. Mean scores of patient satisfaction were 7.43 to 8.63 (range 0 to 10) with no statistically significant difference between the two groups throughout follow up. Adverse effects reported in one study were two plate exposures in each group occurring between the third and ninth months. Plate exposures occurred mainly in the posterior maxillary region, except for one titanium plate exposure in the mandibular premolar region. Known causes of infection were associated with loosened screws and wound dehiscence with no statistically significant difference in the infection rate between titanium (3/196), and resorbable (3/165) plates P = 0.83 (published as P = 0.67).
AUTHORS' CONCLUSIONS: This review provides some evidence to show that there is no statistically significant difference in postoperative discomfort, level of patient satisfaction, plate exposure or infection for plate and screw fixation using either titanium or resorbable materials in orthognathic surgery.
Authors:
Z Fedorowicz; M Nasser; J T Newton; R J Oliver
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Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2007-04-18
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2007  
Date Detail:
Created Date:  2007-04-19     Completed Date:  2007-07-17     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD006204     Citation Subset:  IM    
Affiliation:
Bahrain Branch of the UK Cochrane Centre, Box 25438, Awali, Bahrain. zbysfedo@batelco.com.bh
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Bone Plates*
Bone Screws
Device Removal
Humans
Internal Fixators*
Mandible / surgery*
Maxilla / surgery*
Osteotomy / methods
Randomized Controlled Trials as Topic
Titanium*
Chemical
Reg. No./Substance:
7440-32-6/Titanium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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