Biodegradable plates and screws in oral and maxillofacial surgery

PhD ceremony: Mr. G.J. Buijs, 16.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Biodegradable plates and screws in oral and maxillofacial surgery

Promotor(s): prof. R.R.M. Bos, prof. B. Stegenga, prof. G.J. Verkerke

Faculty: Medical Sciences

Metallic plates and screws are used for immobilization of bone fragments in trauma and orthognathic surgery. Some authors advocate the removal of metallic plates and screws because of potential adverse reactions. Biodegradable fixation systems could reduce or even delete the problems associated with metallic systems since removal is not necessary. The aim of this thesis was to establish the effectiveness and safety of biodegradable plates and screws as a potential alternative to metallic ones. Based on a systematic review it was concluded that there is insufficient scientific evidence for safe and effective use of biodegradable plates and screws in maxillofacial fracture and osteotomies. Furthermore, it was found that the in vitro mechanical properties of titanium plates and screws are superior compared to their biodegradable counterparts. The results of a multi-center randomized clinical trial showed no difference for bone healing 8-weeks after surgery. Despite the ‘non inferior’ primary outcome result, the benefits of using biodegradable systems (less plate removal operations) need to be demonstrated in a long-term follow-up study.