Bioabsorbable plates and screws for fixation of mandibulotomies in ablative oral cancer surgery.

PURPOSE

The use of bioabsorbable self-reinforced poly(L/DL)lactide 70/30 (SR-PLDLA) miniplates and screws could offer many benefits compared with conventional metallic devices for fixation of access osteotomies in oral cancer surgery. The material neither interferes with imaging nor with postoperative radiotherapy. The plates and screws do not need to be removed. The number of operations can be diminished and rehabilitation with dental implants shortened. The purpose of the present study was to report our experience with bioabsorbable osteosynthesis in the fixation of access osteotomies of the mandible.

PATIENTS AND METHODS

A total of 15 patients (11 men and 4 women, mean age 63.1 years) were enrolled in the present study. All patients had oral squamous cell carcinoma. Three patients developed tumor recurrence, 2 of whom had previously undergone radiotherapy. Nine patients had radiotherapy scheduled postoperatively. The osteotomies were a straight-line cut and were situated medially or paramedially. For fixation, SR-PLDLA miniplates and screws (Biosorb 2.0 and 2.4 systems) were used without any maxillomandibular fixation.

RESULTS

The follow-up ranged from 0.3 to 7.1 years (median 3.5). No problems were encountered during the operation. One patient required reoperation owing to failure in fixation. Twelve osteotomy lines (80%) were clinically stable; radiologically, 6 were totally and 3 partly consolidated. During follow-up, 6 nonunions were radiographically noted, 3 of which were clinically stable.

CONCLUSIONS

Because of the high incidence of radiologic nonunion, bioabsorbable devices should not yet be used for fixation of access osteotomies in cancer surgery.