Heat adaptation of bioabsorbable craniofacial plates: a critical review of science and technology.

Bioabsorbable fixation plates often require adaptation to the bone. This is typically accomplished by heating the plates to above the glass transition temperature and placing the softened plates against the bone or a prebent template until cool. Upon cooling, the plates regain stiffness and can be attached to bone to obtain anatomic fixation. This procedure is both efficient and effective and has been used throughout the craniofacial skeleton. There are many types of equipment available to heat the plates, each with advantages and disadvantages. Although a conceptually simple process, there are several nuances that have been reported in the literature, including transient effects on plate mechanical properties, memory effects, differences between wet and dry heating, and others. Upon the backdrop of the overwhelming clinical success of heat adaptation, this review critically evaluates the method and provides a comprehensive examination and explanation of the basic science and technology involved. This should help give surgeons a better understanding of the process that can help improve their use and further advance the technology.