Evaluation of the effect of bio-resorbable plates and screws in the treatment of condylar fractures, assisted by digital preoperative planning

Publication date: Available online 12 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Guangqi Yan, Wenyu Chuo, Ran Zhang, Qing Zhou, Mingliang Yang

Abstract

Purpose

Although bio-resorbable materials have begun to be applied in the clinic, they are primarily used in children with fractures; thus, there are few reports of their application for treatment of condylar fractures. This study aimed to evaluate the effect of the application of bio-resorbable plates and screws for patients with condylar fractures, assisted by digital preoperative planning.

Methods

This was a prospective interventional study. The sample comprised 46 patients treated in the School of Stomatology at China Medical University between October 2016 and May 2018 for condylar fractures, either alone or in combination with other facial fractures. All patients underwent confirmatory preoperative computed tomography (CT) scans to obtain DICOM format data for preoperative designing. By digital designing, the investigators confirmed operative plans for each patient. All 46 patients underwent bio-resorbable osteosynthesis and underwent repeat CT scans on postoperative day 3. Postoperative clinical assessments included postoperative positions of the fracture segments, maximal mouth opening, lateral excursion movements, occlusal status, and patient satisfaction. These variables were used to assess postoperative efficacy.

Results

The sample was composed of 46 patients who had open reduction with internal fixation on 52 sides. At the 3-month follow-up visit, the proportions of patients who were satisfied with the results and who achieved stable occlusion, appropriate maximal mouth opening, and flexible lateral excursion movement were 97, 100, 66, and 95%, respectively. One patient sustained postoperative displacement of condylar fracture fragment, as confirmed by repeated CT scans. He was lost to follow-up at 3 months postoperatively.

Conclusion

The results of this study suggest that open reduction treatment of condylar fractures implanted with bio-resorbable materials in combination with digital preoperative designing is an effective method for managing patients in clinical practice.

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