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生物可吸收接骨板固定下颌体骨折复位后的稳定性:三维分析。

Stability of bioresorbable plates following reduction of mandibular body fracture: Three-dimensional analysis.

机构信息

Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Republic of Korea.

Department of Biostatistics, College of Medicine, Korea University, Republic of Korea.

出版信息

J Craniomaxillofac Surg. 2019 Nov;47(11):1752-1757. doi: 10.1016/j.jcms.2019.07.033. Epub 2019 Aug 7.

Abstract

PURPOSE

The recent development of bioresorbable bone plates and screws allows plates to be applied to the load-bearing regions of the mandible and to remain in place over time without the need for removal. We hypothesized that the stability of composite plates and screws forged from unsintered hydroxyapatite particles and poly-l-lactide (u-HA/PLLA) is comparable to that of standard titanium fixation systems for the reduction of fractures of load-bearing regions of the mandibular body.

MATERIALS AND METHODS

40 patients underwent open reduction and internal fixation of the fractured mandibular body with either a titanium or u-HA/PLLA bone plate. Cone-beam CT images were obtained immediately postoperatively and at 6-month follow-up, and were analyzed for positional changes of the affected mandible.

RESULTS

There were no significant differences in the postoperative positional changes of reference points between the titanium and u-HA/PLLA miniplates, except for that for the coronoid process (p-value = 0.03). Multivariate regression analysis revealed no significant differences in spatial changes between the immediate postoperative and 6-month follow-up images, after adjusting for age and sex.

CONCLUSION

The stability of bioresorbable u-HA/PLLA miniplates and screws was comparable to that of titanium miniplates and screws immediately postoperatively and at 6-month follow-up, following surgical reduction of fractures of load-bearing regions of the mandibular body. Bioresorbable osteosynthesis can be considered a viable alternative to titanium osteosynthesis.

摘要

目的

生物可吸收骨板和螺钉的最新发展使得这些骨板可以应用于下颌骨的承重区域,并随着时间的推移而无需移除。我们假设,由未烧结羟基磷灰石颗粒和聚 L-丙交酯(u-HA/PLLA)锻造而成的复合板和螺钉的稳定性与标准钛固定系统相当,可用于减少下颌骨体承重区域的骨折。

材料与方法

40 名患者接受了开放式复位和内固定治疗下颌骨体骨折,分别使用钛或 u-HA/PLLA 骨板。术后即刻和 6 个月随访时获得锥形束 CT 图像,并对受影响下颌骨的位置变化进行分析。

结果

除了髁突(p 值=0.03)之外,钛和 u-HA/PLLA 微型板术后参考点的位置变化没有显著差异。多变量回归分析显示,在调整年龄和性别后,即刻术后和 6 个月随访图像之间的空间变化没有显著差异。

结论

生物可吸收 u-HA/PLLA 微型板和螺钉的稳定性与钛微型板和螺钉相当,可用于手术复位下颌骨体承重区域的骨折。生物可吸收性骨内固定可以被认为是钛骨内固定的一种可行替代方法。

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