Delayed inflammation after biodegradable and osteoconductive osteofixation in orthognathic surgery
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: This study aims to identify patterns and to describe the clinical course of delayed adverse tissue responses in patients who underwent orthognathic osteotomy with biodegradable osteofixation. Patients and Methods: Through a retrospective review of cases between 2013 and 2020, we identified three patients who underwent bimaxillary osteotomy and fixation with unsintered-hydroxyapatite/poly-L lactic acid (u-HA/PLLA) devices, after which they developed delayed inflammation. These lesions were treated with drainage and/or removal of the devices. Histological evaluations were conducted using H&E staining, and structural changes in the u-HA/PLLA devices were assessed by scanning electron microscopy (SEM). Results: Inflammatory lesions developed only in the mandible, with onset ranging from 12 to 35 months post-operation. Histological studies identified foreign-body granulomas or secondarily infected lesions. SEM analysis indicated biodegradation and tissue integration. Conclusion: Orthognathic patients treated using u-HA/PLLA devices should be informed about the potential for delayed inflammation and monitored for at least 3 years.
Abstract
Objectives: This study aims to identify patterns and to describe the clinical course of delayed adverse tissue responses in patients who underwent orthognathic osteotomy with biodegradable osteofixation. Patients and Methods: Through a retrospective review of cases between 2013 and 2020, we identified three patients who underwent bimaxillary osteotomy and fixation with unsintered-hydroxyapatite/poly-L lactic acid (u-HA/PLLA) devices, after which they developed delayed inflammation. These lesions were treated with drainage and/or removal of the devices. Histological evaluations were conducted using H&E staining, and structural changes in the u-HA/PLLA devices were assessed by scanning electron microscopy (SEM). Results: Inflammatory lesions developed only in the mandible, with onset ranging from 12 to 35 months post-operation. Histological studies identified foreign-body granulomas or secondarily infected lesions. SEM analysis indicated biodegradation and tissue integration. Conclusion: Orthognathic patients treated using u-HA/PLLA devices should be informed about the potential for delayed inflammation and monitored for at least 3 years.
참고문헌 (21)
- Pan Z, "Titanium osteosynthesis hardware in maxillofacial trauma surgery: to remove or remain? A retrospective study", Eur J Trauma Emerg Surg, 40, pp.587~591 (2014)[DOI]
- Siniscalchi EN, "Titanium miniplates : a new risk factor for the development of the bisphosphonate-related osteonecrosis of the jaw", J Craniofac Surg, 24, pp.e1~e2 (2013)[DOI]
- Shand JM, "Use of a resorbable fixation system in orthognathic surgery", Br J Oral Maxillofac Surg, 38, pp.335~337 (2000)[DOI]
- Ngo HX, "A narrative review of u-HA", PLLA, a bioactive resorbable reconstruction material : applications in oral and maxillofacial surgery, 2021, pp.15, 150~
- Al-Moraissi EA, "Biodegradable and titanium osteosynthesis provide similar stability for orthognathic surgery", J Oral Maxillofac Surg, 73, pp.1795~1808 (2015)[DOI]
- Park YW, "Comparative study on long-term stability in mandibular sagittal split ramus osteotomy : hydroxyapatite", poly-L-lactide mesh versus titanium miniplate, 2019, pp.41, 8~
- Kulkarni RK, "Polylactic acid for surgical implants", Arch Surg, 93, pp.839~843 (1966)[DOI]
- Khwanpipat T, "Effect of PDLA and amide compounds as mixed nucleating agents on crystallization behaviors of poly(L-lactic acid)", Materials(Basel), 11, pp.1139~ (2018)[DOI]
- Korzhikov V, "Polyesterbased microparticles of different hydrophobicity : the patterns of lipophilic drug entrapment and release", J Microencapsul, 33, pp.199~208 (2016)[DOI]
- Bergsma JE, "Late degradation tissue response to poly(L-lactide)bone plates and screws", Biomaterials, 16, pp.25~31 (1995)[DOI]
- Rubin JP, "Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery : a comprehensive review of the literature", Plast Reconstr Surg, 100, pp.1336~1353 (1997)[DOI]
- Park YW, "Bioabsorbable osteofixation for orthognathic surgery", Maxillofac Plast Reconstr Surg, 37, pp.6~ (2015)[DOI]
- Shikinami Y, "Bioresorbable devices made of forged composites of hydroxyapatite(HA)particles and poly-L-lactide(PLLA) : part I. Basic characteristics", Biomaterials, 20, pp.859~877 (1999)[DOI]
- Tatsuta S, "Analysis of the postoperative absorption process of unsintered hydroxyapatite particles", poly L-lactide composite device(OSTEOTRANS MX®)for facial bone fractures in 13 cases, 2018, pp.3, 2185~
- Middleton JC, "Synthetic biodegradable polymers as orthopedic devices", Biomaterials, 21, pp.2335~2346 (2000)[DOI]
- Kamata M, "Foreign-body reaction to bioabsorbable plate and screw in craniofacial surgery", J Craniofac Surg, 30, pp.e34~e36 (2019)[DOI]
- Xue AS, "Local foreign-body reaction to commercial biodegradable implants : an in vivo animal study", Craniomaxillofac Trauma Reconstr, 7, pp.27~34 (2014)[DOI]
- Eppley BL, "Use of resorbable plates and screws in pediatric facial fractures", J Oral Maxillofac Surg, 63, pp.385~391 (2005)[DOI]
- Jeon HB, "Delayed foreign body reaction caused by bioabsorbable plates used for maxillofacial fractures", Arch Plast Surg, 43, pp.40~45 (2016)[DOI]
- Böstman O, "Clinical biocompatibility of biodegradable orthopaedic implants for internal fixation : a review", Biomaterials, 21, pp.2615~2621 (2000)[DOI]
- Wittwer G, "Complications after zygoma fracture fixation: is there a difference between biodegradable materials and how do they compare with titanium osteosynthesis?", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101, pp.419~425 (2006)[DOI]