Leno Maria Belén, Liu Stanley Yung, Chen Chien-Tzung, Liao Han-Tsung
Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Craniofacial Research Center, 222, Maijin Road, Keelung, Taiwan.
J Craniomaxillofac Surg. 2017 May;45(5):704-709. doi: 10.1016/j.jcms.2017.01.034. Epub 2017 Feb 13.
The aim of this study is to compare the 1-year functional outcomes and patient-reported satisfaction in treating mandibular fractures between resorbable and titanium fixation devices.
A 1-year prospective study was conducted; 41 consecutive patients presenting with mandibular fractures were included. A resorbable system was used in 21 patients, while in 20 patients a titanium fixation device was used. Functional outcome was evaluated objectively at several time points (2, 4 and 6 weeks, 3 and 6 months, and 1 year after surgery). Bite forces over molars and incisors, mouth opening distance, occlusal status, operation time, fee for implants, bone healing and plate-associated complications were evaluated. Functional and overall satisfaction was measured by patients themselves subjectively.
A statistical difference was found only in maximal mouth opening and molar bite force, both greater for the titanium group in the 2-week time point, achieving comparable measurements in subsequent ones. This coincides with the patient-reported statistically lower satisfaction rates. The cost of the resorbable device was nearly 3 times more expensive than the titanium devices.
Resorbable fixation can achieve stability of bone healing at 1 year postoperatively, with functional and satisfaction outcomes comparable to those associated with titanium hardware from the fourth week postoperatively, while yielding unique advantages.
本研究旨在比较可吸收固定装置和钛固定装置治疗下颌骨骨折的1年功能结局及患者报告的满意度。
进行了一项为期1年的前瞻性研究;纳入41例连续的下颌骨骨折患者。21例患者使用可吸收系统,20例患者使用钛固定装置。在几个时间点(术后2、4和6周,3和6个月,以及1年)客观评估功能结局。评估磨牙和切牙的咬合力、开口距离、咬合状态、手术时间、植入物费用、骨愈合情况及与钢板相关的并发症。功能和总体满意度由患者主观测量。
仅在最大开口度和磨牙咬合力方面发现统计学差异,钛固定组在术后2周时这两项指标更高,后续时间点两者相当。这与患者报告的统计学上较低的满意度相吻合。可吸收装置的费用比钛装置贵近3倍。
可吸收固定在术后1年可实现骨愈合稳定,术后第4周起功能和满意度结局与钛硬件相当,同时具有独特优势。