Stability of craniofacial PLLA/PGA copolymer bioabsorbable screws.

The behavior of bioabsorbable plates and screws after implantation is a dynamic process that results in dimensional changes of the devices after surgery. Bioabsorbable plates frequently are recognized as changing because of their size, but bioabsorbable screws are less appreciated in this regard. How bioabsorbable screws may change after placement and whether their manufacturing method has an influence on size and shape after implantation needs further study. Using 1.5-mm diameter screws made of an oriented copolymer of 82% poly-L-lactic acid and 18% polyglycolic acid (LactoSorb copolymer), screw dimensions were measured before and after soaking in an in vitro pH 7.4, 37 degrees C buffer environment. After 33 days of exposure to buffer, there were no changes in the physical appearance of the screws, and there was no change in dimensions or shape. The orientation of polymer materials in a bioabsorbable screw device improves its strength and can retard the rate of hydrolysis. However, the residual stresses in oriented screws theoretically can potentiate dimensional shift in the implants during hydrolysis. That such shift did not occur during the early phase of hydrolysis provides further evidence of the mechanism by which these types of screws can maintain biomechanical function throughout the bone-healing phase of the craniofacial skeleton.