Toro C, Robiony M, Zerman N, Politi M
Department of Maxillofacial Surgery, Faculty of Medicine, University of Udine, Udine, Italy.
Minerva Stomatol. 2005 Apr;54(4):199-206.
Metallic plates and screws have become the routine way of stabilizing the facial skeleton; however, there are many disadvantages in the use of metallic devices. Fixation systems made of biocompatible absorbable material, with appropriate load-bearing properties and sufficient degradation rate can overcome these disadvantages. Recently, resorbable materials were tested in maxillary, mandibular and chin osteotomies. Despite a lot of reports on the use of resorbable bone fixation devices in cranio-maxillo-facial application are now available, their use in preprosthetic surgery has yet to be adequately documented. The Authors report their 5-year experience in the employment of resorbable fixation in surgery of the superior maxilla, involving orthognathic and preprosthetic procedures of the upper jaws. The surgical technique is described and usefulness and advantages are discussed.
Plates and screws were composed of an 82% poly-L-lactic acid/18% polyglycolic acid copolymer (PLLA-PGA); 50 orthognathic and 5 preprosthetic procedures of upper jaws were involved, performing Le Fort I osteotomies in all cases.
Our operations were were carried out without complications. Follow-up ranged from 6 months to 5 years. One patient developed a localized buccal space infection which resolved after a course of antibiotics given orally.
Resorbable fixation should be considered adequate for fixation in maxillary surgery.
金属板和螺钉已成为稳定面部骨骼的常规方法；然而，使用金属器械存在许多缺点。由生物相容性可吸收材料制成的固定系统，具有适当的承重性能和足够的降解速率，可以克服这些缺点。最近，可吸收材料在上颌骨、下颌骨和颏部截骨术中进行了测试。尽管现在有很多关于可吸收骨固定器械在颅颌面应用中的报道，但它们在修复前手术中的应用尚未得到充分记录。作者报告了他们在使用可吸收固定技术进行上颌骨手术方面的5年经验，包括上颌骨的正颌手术和修复前手术。描述了手术技术并讨论了其有效性和优点。
板和螺钉由82%聚-L-乳酸/18%聚乙醇酸共聚物（PLLA-PGA）组成；涉及50例上颌骨正颌手术和5例上颌骨修复前手术，所有病例均进行了勒福Ⅰ型截骨术。
我们的手术均无并发症发生。随访时间为6个月至5年。1例患者发生局部颊间隙感染，经口服抗生素治疗后痊愈。
可吸收固定在颌骨手术中应被认为是足够的固定方法。
