A randomized control trial comparing between titanium osteosynthesis and biodegradable osteosynthesis in access mandibulotomy for oral malignancy

Publication date: Available online 7 April 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Jian Nan Liu, Ming Yi Wang, Kenneth Wan, Jing Han, Shi Jian Zhang, Xing Zhou Qu, Hui Shan Ong
BackgroundPrevious studies have shown that biodegradable implants can be used in mandibular fixation with optimal result. The effect of post-operative radiotherapy(PORT) on its degradation rate, strength and by-product secretion is not yet known.MethodsA prospective randomized control trial including 40 consecutive mandibulotomy patients randomly divided into either titanium or biodegradable osteofixation cohorts. All patients received PORT. The following parameters were recorded and compared: maximal mouth opening, occlusal force, centre of force trajectory, occlusal status, radiographic evidence of bony union, Mandibular Function Impairment Questionnaire(MFIQ), overall satisfaction score and complication rates.ResultsThere were no statistically significant differences between the biodegradable and the titanium osteosynthesis groups in term of mandibular function or occlusal status. MFIQ scores (p=0.0.089) and overall satisfaction scores (p=0.642) were higher in the biodegradable cohort but the differences were not statistically significant. 40% of patients in the titanium cohort complained of plate palpability/cold intolerance and required plate removal (p=0.028). 10% of patients in the titanium cohort developed osteoradionecrosis. The overall cost of management was higher in the titanium group (p=0.033).ConclusionBiodegradable osteosynthesis is as reliable as titanium osteofixation for access mandibulotomy and yet cost-effective. Post-operative radiotherapy did not increase the complication rate in the biodegradable osteosynthesis group.



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