Kanno Takahiro, Sukegawa Shintaro, Furuki Yoshihiko, Nariai Yoshiki, Sekine Joji
Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine & Maxillofacial Trauma Center, Shimane University Hospital, 89-1 Enyacho, Izumo, Shimane 693-8501, Japan.
Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan.
Jpn Dent Sci Rev. 2018 Aug;54(3):127-138. doi: 10.1016/j.jdsr.2018.03.003. Epub 2018 Apr 5.
Maxillofacial osteosynthetic surgeries require stable fixation for uneventful boney healing and optimal remodeling. Although conventional titanium plates and screws for osteofixation are considered the gold standard for rigid fixation in maxillofacial surgeries, bioresorbable implants of plates and screw systems are commonly used for various maxillofacial osteosynthetic surgeries such as orthognathic surgery, maxillofacial fractures, and reconstructive surgery. Titanium plates are limited by their palpability, mutagenic effects, and interference with imaging, which may lead to the need for subsequent removal; the use of a biologically resorbable osteofixation system could potentially address these limitations. However, several problems remain including fundamental issues involving decreased mechanical strength and stability, slow biodegradation, complex procedures, and the available bioresorbable implant materials. Major advances in bioresorbable plate systems have been made with the use of bioactive/resorbable osteoconductive materials and an accelerator of bioresorption, such as polyglycolic acid. This report presents an overview of currently available resorbable implant materials and their applications, with a focus on recent innovative advances and new developments in this field.
颌面骨合成手术需要稳定固定,以实现顺利的骨愈合和最佳的重塑。尽管传统的用于骨固定的钛板和螺钉被认为是颌面手术中刚性固定的金标准,但可生物吸收的板和螺钉系统植入物常用于各种颌面骨合成手术,如正颌手术、颌面骨折和重建手术。钛板存在可触知性、诱变效应以及对成像的干扰等局限性,这可能导致后续需要取出;使用生物可吸收骨固定系统可能会解决这些局限性。然而,仍然存在一些问题,包括涉及机械强度和稳定性降低、生物降解缓慢、程序复杂以及可用的生物可吸收植入材料等基本问题。通过使用生物活性/可吸收骨传导材料和生物吸收促进剂(如聚乙醇酸),生物可吸收板系统取得了重大进展。本报告概述了目前可用的可吸收植入材料及其应用,重点关注该领域最近的创新进展和新发展。