Kim Byung Jun, Piao Yinglan, Wufuer Maierdanjiang, Son Woo-Chan, Choi Tae Hyun
Clinical Associate Professor, Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
Graduate School Student, Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Oral Maxillofac Surg. 2018 May;76(5):1055.e1-1055.e9. doi: 10.1016/j.joms.2018.01.015. Epub 2018 Feb 2.
A biodegradable magnesium alloy system has been developed as a substitute for conventional plates and screws made of titanium or absorbable polymer. However, previous studies were limited to small animal experiments using screws or wires. In the present study, we preliminarily evaluated the biocompatibility and effectiveness of human standard-size biodegradable magnesium-based plates and screws in facial fractures of beagles.
Fracture lines were created bilaterally in the zygomatic arches of 6 beagles. They were fixed in situ with plates and screws made of magnesium alloy mixed with calcium and zinc (experimental group) or absorbable polymer (control group). Laboratory testing, radiologic imaging, histologic analysis, and mechanical testing were performed 4 weeks postoperatively.
Inflammatory reactions were not significantly increased in any animal. Mechanical testing showed greater ultimate load and structural stiffness in the experimental group. In the histologic analysis, the void area and bone regeneration area were increased in the experimental, and the implant area and soft tissue area were increased in the control group. Radiologically, 3-dimensional micro-computed tomography showed no differences in the bone gap area between the 2 groups. A temporary increase in hydrogen gas around the magnesium implants regressed spontaneously and did not affect bone healing significantly.
Magnesium-based biodegradable plates and screws showed good biocompatibility and offered considerable stability for fixating facial bone fractures in the early bone-healing process. These results show the possibilities for the future development of magnesium alloy plates and screws for craniomaxillofacial fixation in humans.
已开发出一种可生物降解的镁合金系统,以替代由钛或可吸收聚合物制成的传统钢板和螺钉。然而,先前的研究仅限于使用螺钉或金属丝的小动物实验。在本研究中,我们初步评估了人类标准尺寸的可生物降解镁基钢板和螺钉在比格犬面部骨折中的生物相容性和有效性。
在6只比格犬的双侧颧弓处制造骨折线。用混合有钙和锌的镁合金制成的钢板和螺钉(实验组)或可吸收聚合物(对照组)对骨折进行原位固定。术后4周进行实验室检测、放射成像、组织学分析和力学测试。
任何动物的炎症反应均未显著增加。力学测试显示实验组的极限载荷和结构刚度更大。组织学分析显示,实验组的空隙面积和骨再生面积增加,而对照组的植入物面积和软组织面积增加。放射学上,三维微计算机断层扫描显示两组之间的骨间隙面积无差异。镁植入物周围氢气的暂时增加自发消退,对骨愈合无显著影响。
镁基可生物降解钢板和螺钉显示出良好的生物相容性,并在早期骨愈合过程中为固定面部骨折提供了相当大的稳定性。这些结果显示了镁合金钢板和螺钉未来用于人类颅颌面固定的发展可能性。