The Dilemma Of Pediatric Mandible Fractures: Resorbable Or Metallic Plates?

Filinte, Gaye Taylan; Akan, Ismaíl Míthat; Çardak, Gülçin Nujen Ayçiçek; Mutlu, Ozay Ozkaya; Aköz, Tayfun

doi:10.5505/tjtes.2015.23922

Cited by 8 publications

(23 citation statements)

References 18 publications

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“…The included studies consisted of 7 publications of RCTs 2,14,33-37 , of which 4 were publications of a single RCT, each with a different FU 2,33,35,36 , 4 prospective cohort studies 11,13,38,39 , and 13 retrospective cohort studies 8,40,[49][50][51][41][42][43][44][45][46][47][48] . Low risk of bias was observed in the 'random sequence generation' domain in all but one of the included RCTs (Table 1).…”

Section: Assessment Of Methodological Qualitymentioning

confidence: 99%

“…Ages ranged from 4 to 83 years. Two studies only included paediatric patients 48,49 . The most common types of fractures were mandibular, zygomatic and maxillary fractures.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The most common types of fractures were mandibular, zygomatic and maxillary fractures. Ten studies solely included patients with mandibular fractures 8,11,13,14,34,38,42,46,47,49 , while six studies included patients with only zygomatic fractures 37,39,41,43,44,50 . The remaining studies included various types of fractures (e.g., Le Fort or orbital fractures) 2,33,35,36,40,45,48,51 .…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Comminuted fractures were excluded in 16 studies 13,14,43,44,46,47,50,[33][34][35][36]38,39,41,42 , while two studies did not exclude these type of fractures 8,45 . The remaining six studies did not report specific in-or exclusion criteria regarding comminuted fractures 11,37,40,48,49,51 . Four studies included both orthognathic and trauma patients, but only the trauma patients' data have been included in this review 2,33,35,36 .…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

Gareb

Bakelen

Dijkstra

et al. 2020

International Journal of Oral and Maxillofacial Surgery

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Titanium osteosynthesis is currently the fixation system of choice in maxillofacial traumatology.Biodegradable osteosynthesis systems have the ability to degrade in the human body. The aim of this study was to conduct a systematic review, with meta-and trial sequential analyses, to assess the efficacy and morbidity of biodegradable versus titanium osteosyntheses after maxillofacial trauma. MEDLINE, EMBASE, and CENTRAL were searched for randomized controlled trials, and prospective and retrospective controlled studies. Five time periods were studied: perioperative, short-term (0-4 weeks), intermediate (6-12 weeks), long-term (>12 weeks) and overall follow-up. After screening 3542 records, 24 were included. All had a high risk of performance and detection bias due to the nature of the interventions. Meta-analysis showed no differences in efficacy and morbidity between biodegradable and titanium osteosyntheses. Risk of perioperative screw breakage was significantly higher (RR 17.13, 95% CI: 2.19;34.18) and the symptomatic plate removal rate lower in the biodegradable group (RR 0.11; 95% CI 0.02;0.57), which was confirmed by the trial sequential analysis. The quality of evidence ranged from very low to moderate. Based on both narrative review and meta-analyses, current evidence shows that biodegradable osteosyntheses are a viable alternative to titanium osteosyntheses when applied in the treatment of maxillofacial trauma with similar efficacy but significantly lower symptomatic plate removal rates. Perioperative screw breakage occurred significantly more often in the biodegradable compared to the titanium group.

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Section: Assessment Of Methodological Qualitymentioning

confidence: 99%

“…Ages ranged from 4 to 83 years. Two studies only included paediatric patients 48,49 . The most common types of fractures were mandibular, zygomatic and maxillary fractures.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

Gareb

Bakelen

Dijkstra

et al. 2020

International Journal of Oral and Maxillofacial Surgery

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“…O tratamento das fraturas mandibulares pode ser realizado de forma conservadora, através de bloqueio maxilomandibular rígido, ou cirúrgico por meio de redução aberta e osteossíntese utilizando placas e parafusos de titânio5. Nos casos de pacientes pediátricos, a fixação através de materiais absorvíveis é indicada por apresentar a vantagem de uma única abordagem cirúrgica sem necessidade de retirar o material de fixação como ocorre com as placas a parafusos de titânio, no entanto, a curva de aprendizado do cirurgião, o custo elevado, bem como a diminuição da estabilidade frente às forças mastigatórias deve ser levada em consideração 6 .…”

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Tratamento interdisciplinar de fratura mandibular em criança politraumatizada

Pomponi¹,

Kasaya

Pereira³

et al. 2021

Arch Health Invest

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Introdução: As fraturas faciais pediátricas possuem menor incidência e fatores como a presença dos germes dos dentários e o crescimento crânio faciais em desenvolvimento exigem maior atenção do cirurgião bucomaxilofacial. Objetivo: relatar caso clínico de fratura mandibular múltipla em paciente pediátrico e evidenciar a importância do atendimento multidisciplinar no tratamento do paciente politraumatizado. Caso Clínico: Paciente do gênero feminino, cinco anos, vítima de acidente automobilístico com trauma facial e cranioencefálico foi admitida no pronto socorro. Após diagnóstico e tratamento do trauma cranioencefálico (drenagem cirúrgica de hematoma extra-dural) a paciente foi abordada pela equipe de cirurgia buco maxilo facial para a realização de osteossíntese das fraturas de sínfise à direita, corpo mandibular esquerdo e do processo alveolar em região dos elementos dentários 73 e 83. Devido à idade da paciente, possivelmente não colaborativa no pós-operatório e a complexidade da fratura dentoalveolar na região anterior mandibular, optou-se pela remoção da tábua óssea vestibular que continha os dentes anteriores inferiores decíduos e a exodontia do elemento 31 não erupcionado que impossibilitava seu reposicionamento adequado. Uma prótese parcial removível provisória foi confeccionada para a reabilitação protética. Após 6 meses de proservação foi realizada a remoção dos materiais de síntese e a paciente encontra-se em bom estado geral, sem queixas álgicas e/ou sinais de infecção. Conclusão: O tratamento das fraturas em crianças pode ser realizado com uma boa previsibilidade de sucesso, por meio da fixação com placas e parafusos de titânio, sendo que as mesmas devem ser removidas em um segundo procedimento cirúrgico.

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Comparing maximal forces in resorbable poly-L-lactic acid and titanium plates for mandibular fracture fixation

Burns

Fields

Farinas

et al. 2020

Heliyon

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Treatment for mandibular fractures is commonly performed via open reduction fixation with mini titanium or resorbable plates and screws. The investigators hypothesized differences in maximum mechanical stress forces and deflection with each plating material; however, it was proposed that the experimental forces withstood by the resorbable system would be enough to withstand normal forces produced during mastication.The sample was composed of fresh cadaver mandibles that were harvested, fractured, and fixated with plates and screws. The predictor variable was fracture fixation and included a titanium plating or resorbable poly-Llactide plating system. The primary outcome measure was maximum load withstood before plating failure measured in Newtons (N). Descriptive and bivariate statistics were computed, P value was set at .05.The sample was composed of six mandibles with and grouped by type of fixation modality, Titanium (T) (n ¼ 3) and Resorbable (n ¼ 3). There was a statistically significant correlation between the T group and increased maximum load (N) before failure as compared to the R group, (P ¼ 0.023).The results suggest that fracture fixation with titanium plates and screws can withstand greater maximum forces before failure; however, the resorbable plating system withstood forces similar to/or greater than the maximum forces produced during normal mastication.

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The Dilemma Of Pediatric Mandible Fractures: Resorbable Or Metallic Plates?

Abstract: BACKGROUND:The aim of this study was to compare the efficiency of resorbable and metallic plates in open reduction and internal fixation of mandible fractures in children.

Cited by 8 publications

References 18 publications

Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

Tratamento interdisciplinar de fratura mandibular em criança politraumatizada

Comparing maximal forces in resorbable poly-L-lactic acid and titanium plates for mandibular fracture fixation

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