Abstract
Titanium alloys are used in skeletal surgery. However, once bone union is complete, such fixation material becomes unnecessary or even harmful. Resorbable magnesium materials have been available for several years (WE43 alloy). The aim of this study was to clinically compare magnesium versus titanium open reduction and rigid fixations in mandible condylar heads. Ten patients were treated for fractures of the mandibular head with magnesium headless compression screws (2.3 mm in diameter), and 11 patients were included as a reference group with titanium screws (1.8 mm in diameter) with similar construction. The fixation characteristics (delay, time, and number of screws), distant anatomical results (mandibular ramus height loss, monthly loss rate, and relative loss of reconstructed ramus height), basic functional data (mandibular movements, facial nerve function, and cutaneous perception) and the influence of the effects of the injury (fracture type, fragmentation, occlusion, additional fractures, and associated diseases) on the outcome were evaluated. The long-term results of treatment were evaluated after 18 months. Treatment results similar to those of traditional titanium fixation were found with magnesium screws. Conclusions: Resorbable metal screws can be a favored option for osteosynthesis because surgical reentry can be avoided. These materials provide proper and stable treatment results.
Highlights
Titanium alloys are used in skeletal surgery, in both children [1,2,3] and adults [4,5,6,7].Long screw fixation through the lateral fragment end of the ascending ramus has been a well-known procedure for osteosynthesis of the condylar head for approximately the last 30 years [8]
The stability of bone fragments fixed by magnesium screws weakens with time after osteosynthesis
This study shows the clinical advantages of using magnesium resorbable screws for the fixation of fractures of the mandibular heads, obviously achieving union of the bone fragments and restoring the range of contralateral movement in relation to the fractured head and clinically insignificant complications
Summary
Titanium alloys are used in skeletal surgery, in both children [1,2,3] and adults [4,5,6,7].Long screw fixation through the lateral fragment end of the ascending ramus (i.e., distal fragment) has been a well-known procedure for osteosynthesis of the condylar head for approximately the last 30 years [8]. For most of that time, titanium alloy screws were used. This is partly due to the need for low-profile screws in the mandibular head [9]. Either cannulated [10] or solid [11], are used in the mandibular head. This solves many clinical issues and prevents iatrogenic destruction of mandibular head fragments by screws that are too thick. Titanium alloys are not resorbable in the human body For this reason, resorbable materials [15,16,17] are sought for mandibular head surgery
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