Titanium Microplate Research Articles

Reconstruction of laryngeal function by thyroid cartilage fenestration and draw-out resection followed by internal fixation with titanium microplates for early glottic carcinoma: a novel and efficient surgical approach.

To explore the clinical effectiveness of reconstructing laryngeal function using thyroid cartilage fenestration and "draw-out" resection, supplemented by internal fixation with titanium microplates in early glottic carcinoma. Data from 99 patients with glottic carcinoma treated in the Second Affiliated Hospital of Fujian Medical University between January 2014 and September 2021 were retrospectively analyzed. Forty-eight patients who underwent thyroid cartilage fenestration and resection followed by internal fixation with titanium microplates for laryngeal function reconstruction were assigned to the thyroid cartilage fenestration group (TCF group), while the other 51 patients who underwent sternohyoid muscle and fascia repair for laryngeal function reconstruction were assigned to the sternohyoid muscle repair group (SMR group). Patients were followed up for 1-8 years. Data on postoperative phonatory function, respiratory function, swallowing function, and survival status were collected. Compared to the SMR group, patients in the TCF group showed better postoperative recovery in phonatory function and verbal communication (all P<0.05). In the TCF group, patients demonstrated stable respiration and the extubation rate was 100.00%, which was significantly higher than 82.35% in the SMR group (P<0.05). Patients in both groups showed good postoperative recovery of swallowing function (P>0.05). One-stage reconstruction of laryngeal function by thyroid cartilage fenestration and "draw-out" resection with adjuvant internal titanium microplate fixation in early glottic carcinoma demonstrates good postoperative recovery and good preservation of the laryngeal function.

A Temporary Intraoperative Fixation Method for the Absorbable Plates Fixation of Condylar Fracture by Retromandibular Transparotid Approach.

The authors describe a temporary intraoperative fixation method for the absorbable plates' fixation of subcondylar fracture by retromandibular transparotid approach. First, the fracture was temporarily fixed with a 4-hole titanium microplate across the fracture line in the center of the lateral surface of the condyle to maintain the reduction of the fracture. Then, two 4-hole absorbable mini-plates were fixed on the posterior and anterior border of the condylar neck. Finally, the 4-hole titanium microplate and screws were removed before the wound closure. In the absorbable plates' fixation of subcondylar fracture by transparotid approach, the method of temporary intraoperative fixation using a 4-hole titanium microplate offsets the limited exposure of the operative field, smooths the operation, and offers the reliability and validity of the absorbable plates' fixation.

Digital Mapping of a Massive Skull-Base Ameloblastoma with Intracranial Extension, Resection, and Reconstruction Using 3D Templates and Molds: Descriptive Case Report and Review

Radical surgery is the mainstay for the treatment of recurrent ameloblastomas; however, it leads to large, complex defects. In this case report, we present an innovative technique of digitally aided resection and reconstruction. A massive histologically confirmed acanthomatous ameloblastoma of the skull-base was digitally mapped with the help of three-dimensional (3D) computed tomography and a custom resection template was fabricated. Digital resection of the skull-base tumor with intracranial extension was done virtually and the resultant defect was reconstructed to create an anatomical replica of the contralateral unaffected side. The tumor was successfully resected with adequate margins guided by the resection template to avoid injury to adjacent vital structures. Subsequent reconstruction was performed by first adapting polymethyl methacrylate bone cement into a series of custom-made 3D molds. Once set, this bone cement served as a reconstructive implant to bridge the ablative defect. The implant offered a precise fit and was secured to healthy adjacent bone using titanium microplates. We present a 6-month follow-up of the case with satisfactory aesthetic results. 3D printing technology has the potential to revolutionize the arena of craniofacial resection with excellent cosmesis and no donor site morbidity if applied appropriately as described here.

Incorporation of Plant Extracted Hydroxyapatite and Chitosan Nanoparticles on the Surface of Orthodontic Micro-Implants: An In-Vitro Antibacterial Study.

In our study, the structural and morphological applications of hydroxyapatite and chitosan nanoparticles and coated micro-implants were assessed for their ability to combat oral pathogenic bacteria. The hydroxyapatite, as well as chitosan nanoparticles, were synthesized from the Salvadora persica plant. The crystal morphology, phase composition, particle size, and surface functional groups of the nano-samples were analyzed via classical examinations and energy dispersive X-ray analysis. The prepared nanoparticles have been examined for antibacterial activity against four common oral bacterial strains. The antimicrobial effect was also assessed by the Live/Dead BacLight technique in combination with confocal scanning laser microscopy. Titanium micro-implants were coated with regular hydroxyapatite (HAP) and chitosan nanoparticles, and the surface was characterized by scanning electron microscopy. The analysis asserted elemental composition of the prepared nanoparticles and their textural features, metal crystallization, and functional bonds. The antibacterial activity of the nanoparticles was evaluated against oral pathogenic microorganisms by the disc diffusion method, minimum bacterial concentration (MBC), and minimum inhibitory concentration (MIC). Chitosan nanoparticles showed (MICs) of 8 μg mL−1 for (Streptococcus salivarius, Streptococcus mutans and Enterococcus faecalis), and 16 μg mL−1 for Streptococcus sanguinis. HAP nanoparticles showed (MICs) of 16 μg/mL for E. faecalis, and S. sanguis, 8 μg/mL for S. salivarius and finally 4 μg/mL for S. mutans. HAP nanoparticles showed enhanced antibacterial activity and more obvious damage in the bacterial cell membrane than that of synthesized chitosan nanoparticles. The prepared nanoparticles could successfully coat titanium microplates to enhance their efficiency.

Le Fort I İlerletme Osteotomisi Sonrası Farklı Fiksasyon Sistemlerinin Biyomekanik Olarak Karşılaştırması: İn Vitro Çalışma

Background: The aim of this study is to explore the effect of five different plate-screw systems on the stability after LeFort I osteotomy in polyurethane skull models. Also, we aimed secondarily to evaluate the efficiency of the use of micro and bioabsorbable fixation systems especially in the regions where the muscularity is relatively thin, in providing enough stability.&#x0D; Methods: Standard titanium miniplates, titanium microplates and bioabsorbable plates were applied for the internal fixation of artificially created LeFort I osteotomy on polyurethane skulls. Load applied in inferior-superior direction to simulate bite forces. The load-displacement values were recorded.&#x0D; Results: Significant differences were observed among the displacement values of five fixation systems at 120, 150, 180 and 200 N of loading (p&lt; 0.05). The highest displacement values were observed in the 4RLt-Micro group with the increasing load. The 4RLt-Mini and 4LLt-Mini groups showed the least displacement values, and the 4LLt-Mini group showed less displacement than the 4RLt-Mini group. The 2Lt/2It- Mini and 2Lt/2Ir-Mini groups showed proximate displacement values with the 4RLt-Mini and 4LLt-Mini groups.&#x0D; Conclusions: The results of this study show that the left sided L miniplates provide more stable results than the right sided ones. Also, it may be said that while sufficient stability can be obtained, the problem of palpability is also eliminated with the use of bioabsorbable plates in the regions with thin muscularity in combination with standard titanium miniplates. However, further in vitro and in vivo studies with wider advancement values needs to be conducted to confirm these results.

Case report on management of frontal sinus fracture using foley catheter balloon inflation

The frontal sinus fracture management is complicated due to its anatomical location. Several classifications have been made to facilitate the methods of treatment which varies from simple conservative observation to complex surgical intervention.The main goal is to achieve “safe functional sinus” either conservatively or surgically. Many surgical approaches have been employed to access the sinus, however, less invasive techniques are currently being utilized.Previously, endoscopic reduction by inflating a balloon catheter was used to tread displaced orbital floor and frontal sinus through their ostia in the nasal cavity, however, no fixation was mentioned after maintaining reduction.This case report will briefly describe frontal sinus reduction using balloon inflation and fixation via titanium microplates through an existing laceration.

Use of osteosynthesis titanium microplates in rhinoplasty

AbstractEven in the most difficult clinical scenario of reconstructive rhinoplasty, a solid fixation of the nasal L‐strut is possible. Fixation by using titanium microplates screwed to the facial skull has proved to be stable two years after surgery, providing a good outcome.

ПЕРЕЛОМЫ СКУЛОВЕРХНЕЧЕЛЮСТНОГО И СКУЛО-ОРБИТАЛЬНО-ВЕРХНЕЧЕЛЮСТНОГО КОМПЛЕКСОВ

During the period 2017-2021, 112 patients with fractures of the zygomaticomaxillary and zygomatic-orbito-maxillary complexes were diagnosed and surgically treated. The patients were divided into 2 groups. In the first group, after a comprehensive study of the clinical and radiological picture of the injury area, 86 patients were treated in the traditional way. The essence of the method was to create access through a small puncture-incision along the lower edge of the zygomatic bone and perform the reposition of fragments using the hook of A.A. Limberg. The remaining 26 patients were treated with open reposition and rigid fixation of bone fragments with transconjunctival, intraoral, and sometimes blepharoplastic incisions using titanium microplates and micro-screws. The results of the “traction test” were checked to identify the infringement of the lower oblique muscle of the eyeball. A computed tomography scan revealed a symptom of a “hanging drop” in combination with damage to the bottom of the eye socket. Despite such disadvantages as the need for a longer intervention, high financial costs and additional skills of the operating surgeon, after the treatment of the second group of patients, there was a decrease in postoperative complications and thus an improvement in the results of surgical treatment.

Miniplates coated by plasma electrolytic oxidation improve bone healing of simulated femoral fractures on low bone mineral density rats

The treatment of polytrauma patients represents a great challenge in the maxillofacial and orthopedic surgery fields. Therefore, this study tested the hypothesis that the use of a bioactive coating (by plasma electrolytic oxidation, PEO) on titanium microplates could improve the fracture healing of low bone mineral density (BMD) rats. Thirty female rats underwent bilateral ovariectomy surgery (OVX), and 35 rats underwent fake surgery (SHAM). Three months later, animals were subjected to femoral fracture simulation and were fixed with either non-coated (CONV) or coated (PEO) titanium miniplates. Eight weeks postoperatively, microplate/bone complexes were analyzed through computed microtomography, histometric, confocal microscopy, molecular, and biomechanical analysis. Bioactive elements (Ca and P) were incorporated on the PEO microplate and the surface was modified in a volcano-like structure. In the microCT analysis the OVX/PEO group had greater values for Tb.Th (bone trabecular thickness), Tb.Sp (separation of bone trabeculae) and Tb.N (number of trabeculae) parameters compared to the OVX/CONV group. According to histometric analysis, the OVX/PEO group showed significantly higher new bone formation than the OVX/CONV group (P < 0.05). For the fluorochrome area, the OVX groups (PEO and CONV) showed greater values for calcein precipitation (old bone) than alizarin red (new bone). Molecular results showed greater values for proteins related to the final phase of bone formation (P < 0.05) in the OVX/PEO group. The OVX/PEO group showed higher bone/miniplate system resilience compared to the others (P < 0.05). It was concluded that PEO coating optimizes bone healing on simulated femoral fractures in low bone mineral density rats. This sheds new light in the treatment of osteoporotic patients with bone fractures.

The effects of local and intraperitoneal zinc treatments on maxillofacial fracture healing in rabbits

ObjectiveThis study aimed to determine whether administration of topical and intraperitoneal zinc for maxillofacial fractures has any impact on the bone healing process. Material and methodThirty-two New Zealand rabbits were randomly assigned to four groups of eight each. The first group was the control group; fracture lines were fixed using titanium microplates and no medication was administered. The second group received fixations using zinc-coated titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the third group following fixations with titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the fourth group following fixations with zinc-coated titanium microplates. Zinc coating on to the titanium microplates was achieved using the physical vapor deposition technique. A fracture line was created in the nasal bones of all subjects and fixed with five-hole flat microplates and three 5-mm micro screws. All work groups were sacrificed at the end of the sixth week. ResultsHistological examination showed that the number of osteoblasts were significantly higher in zinc-coated group (Group 2) than zinc uncoated, control group (Group 1), (415.6 ± 46.7 vs 366.3 ± 11.8) (p < 0.001). It was observed that intraperitoneal zinc treatment alone (Group 3) did not significantly increase in the osteoblast count compared to zinc un-coated group (Group 1), (390.6 ± 83.2 vs 366.3 ± 11.8), (p = 0.341). The immunoreactivity scores for IGF-1 were significantly higher in the zinc-coated group compared to control group (Group 2 vs 1), (9.3 ± 2.8 vs 3.7 ± 1.9) (p < 0.05). It was observed that intraperitoneal zinc treatment did not cause a significant difference in the aspect of IGF-1 for zinc-coated groups (Group 2 vs 4) (9.3 ± 2.8 vs 9.6 ± 2.2) (p = 0.791). The difference in the immunoreactivity score among whole groups for TGF-β was not statistically significant (Group 1 vs 2, 3.2 ± 1.7 vs 4.4 ± 2.3, p = 0.256; Group 1 vs 3, 3.2 ± 1.7 vs 3.8 ± 2.8, p = 0.524; Group 1 vs 4, 3.2 ± 1.7 vs 2.8 ± 1.3, p = 0.717; Group 2 vs 3, 4.4 ± 2.3, vs 3.8 ± 2.8, p = 0.610; Group 2 vs 4, 4.4 ± 2.3, vs 2.8 ± 1.3, p = 0.124; Group 3 vs 4, 3.8 ± 2.8, vs 2.8 ± 1.3, p = 0.311). ConclusionThe local use of titanium microplates coated with zinc by PVD technique was found effective for fracture healing. Zinc coating of titanium microplates used in fracture treatment can accelerate fracture healing. It may be concluded that clinical studies should be performed now in order to explore if comparable results can be achieved in humans.

A Novel Medial Canthal Reconstruction Technique in Children With Blepharophimosis Syndrome.

There are different techniques for medial canthoplasty in blepharophimosis syndrome where individuals have epicanthus inversus and telecanthus leading to typical facial appearances. These methods have potential problems with scarring, epistaxis, and extrusion of metal plates. The authors describe a novel technique of medial canthal reconstruction using titanium microplates with microscrew fixation to the anterior lacrimal crest, with effective, safe, and reproducible results. Seven children with blepharophimosis syndrome underwent medial canthus reconstruction surgery at a single center with the collaboration of a pediatric oculoplastic surgeon and craniofacial plastic surgeon to improve eye opening through correction of the lid contours and telecanthus. This is a safe, effective, and reproducible technique, with minimal morbidity and rapid postoperative recovery in children. It produces cosmetically acceptable scars and a strong stable reconstruction of the medial canthal insertion.

The Use of Microplates for Internal Fixation of Comminuted Mandibular Fractures.

Although clinical trials have successfully applied microplates for the internal fixation of single or double isolated mandibular fractures, the use of microplate systems in comminuted mandibular fractures is not widely accepted. This study aimed to evaluate the use of microplates for internal fixation of comminuted mandible fractures and to discuss their applicability. Fourteen patients with comminuted mandibular fractures (10 at a single region, 3 at 2 regions, and 1 at 4 regions) were treated with open reduction and internal fixation using 0.5- or 0.6-mm-thick titanium microplates and 1.0-, 1.2-, or 1.3-mm monocortical microscrews. Three-level fixation at the lower border, upper border (as interdental wiring), and middle of the mandible was performed. Maxillomandibular fixation was applied only when premature occlusal contact was observed after fracture fixation. During the follow-up period (3-55 months), all fractures showed favorable and complete bone healing. Six patients experienced minor complications, including minimal malocclusion (n = 5) and a localized infection (n = 1). Most of these complications were managed with conservative treatment. No major complications that required further orthodontic treatment or reoperation occurred. These results suggest that 3-level fixation using microplates is appropriate for the reconstruction of comminuted mandibular fractures without bony defects. The small size and malleability of these devices facilitate accurate anatomical reduction for complete contact of the comminuted bony segments by multiple fixation. Furthermore, microplates allow for preservation of sufficient periosteal blood supply and restoration of premorbid occlusion (by occlusal self-adjustment) while providing sufficient stability.

Biomaterials used in Reduction and Fixation of Unstable Fractures of the Zygomaticomaxillary Complex

This study evaluated a series of cases of fracture in the zygomaticomaxillary complex with displacement of the fractured segment which were evaluated before and after treatment with cone beam CT. The treatment perfomed was represented by titanium micro-plates and screws. The study sample which consist of 25 patients of both genders with fractures in the zygomaticomaxillary bones. After clinical examination to arrive at correct diagnosis and treatment plan, each patient was subjected to 2D and 3D reconstruction using cone beam CT. Reffering to the type of treatment was evaluated the procces of bone remodelling and also the osseointegration process of the titanium micro-plates and screws used for reduction and fixation of the fractures. The treatment performed for all patients was reduction and fixation with titanium micro-plates which were osseointegrated partially in 45 % of patients and 3 screws were not osseointegrated.

Is the Mandibular Growth Affected by Internal Rigid Fixation?: A Systematic Review.

The purpose of this systematic review was to evaluate, in animal model-based studies, whether there are mandibular growth alterations, after open reduction and internal rigid fixation with titanium plates and screws. A literature search was conducted using the MEDLINE, EMBASE, and LILACS databases, up to and including August 2015. Surgical reduction and internal rigid fixation (IRF) of induced fractures were compared to non-invasive procedures, in order to investigate if there were alterations in the mandibular growth patterns. Of a total of 624 potentially relevant papers identified through the searching process, five were eligible for inclusion. Three studies using 3-month old New Zealand white rabbits induced fractures of mandibular body or symphysis and internal fixation with titanium microplates and screws, whereas two were based on 6-month old goats with condylar fracture. None of the studies showed statistically significant difference between experimental and control groups. As literature regarding this subject is scarce, and the included studies show low level of evidence, it is not possible to conclude that open reduction and internal rigid fixation with titanium plates and screws cause significant growing alteration of the mandible.

Reduction of Zygomatic Complex Fracture Using Combination of Microplate and Miniplate Osteosynthesis

Zygomaticomaxillary complex (ZMC) fracture is the second most common facial bone fractures after nasal bone and has been extensively described in the literature. Numerous techniques have been described for the reduction of ZMC fracture. This case report presents a 21-year-old man who was involved in a traffic accident and who subsequently presented with a ZMC fracture. The patient was treated through an open reduction and internal fixation procedure using a titanium microplate and miniplate combination.

Use of a Titanium Microplate to Anchor Subunit Reconstruction at the Nasal-Cheek Junction.

Reconstruction of combined nose, cheek, and/or inferior eyelid defects is facilitated by stable anchorage at the nasal-cheek junction. The previously reported techniques of drill holes and Mitek anchors are not without disadvantages. The authors present a simple means of anchoring soft tissue flaps at the nasal-cheek junction: a titanium miniplate secured with a screw at each end. Our case report describes successful, lasting, and complication-free anchorage of cheek, forehead, and eyelid flaps to a single miniplate placed along the piriform aperture.

Individualized Surgical Templates and Titanium Microplates for Le Fort I Osteotomy by Computer-Aided Design and Computer-Aided Manufacturing.

The authors report the use of novel individualized surgical templates and titanium miniplates for Le Fort I osteotomy and evaluate the accuracy of this technique in vitro. Nine three-dimensional stereolithographic skull models were used to design the templates and titanium microplates and to simulate the operation. Cone beam computed tomography (CBCT) scans of the skulls were acquired preoperatively and were used to generate virtual models. The surgical plans were made based on three-dimensional cephalometric analyses, and osteotomies were then performed virtually. Cylinder-shaped markers were placed to permit the correct location of titanium screws, and individualized surgical templates were designed. The bony segments were then repositioned virtually according to the surgical plans to correct the skeletal deformities. Resin surgical templates were produced by stereolithography rapid prototyping and the titanium miniplates by three-dimensional cutting. Le Fort I osteotomy was performed under the guide of the surgical templates and fixed with the titanium miniplates. Postoperatively, CBCT scans of each skull model were taken, and the differences between the actual and planned surgical outcomes were measured by superimposing the planned and postoperative virtual models generated from CBCT images. The authors demonstrated that the average linear difference between the planned and actual outcomes was <1 mm and the average orientation difference was <1°. The individualized surgical templates and titanium microplates designed in this experimental study permitted the repositioning of the maxillary segment to the correct planned positions during Le Fort I osteotomy, making this technique a promising alternative to the conventional split method.

Temporary removal of the posterior bony canal wall with reconstruction using microplate osteosynthesis in cholesteatoma surgery: a case series and description of the technique

We describe the surgical technique of temporary removal of the posterior auditory canal wall with reconstruction and report the outcome of using this technique as a treatment method for cholesteatoma in a case series. In 32 cases of cholesteatoma surgery a technique of temporary removal of the posterior bony wall was applied. During primary surgery the posterior auditory canal wall was removed using an oscillating saw. For the purpose of reconstruction, the canal wall was repositioned and fixed using two titanium microplates (n = 26). In case the canal wall could not be reconstructed with osteosynthesis, either glass-ionomeric cement (BioCem™) was used for fixation (n = 4) or fibrin glue (Tissucol™) (n = 2) to support the posterior wall. The outcome includes the healing process in the first postoperative month, the absence of residual or recurrent disease and the successful reconstruction of the posterior auditory canal wall as evaluated during second-look surgery. When microplates where used, we saw healing problems of the canal skin in about 4% of patients. Recurrent cholesteatoma was found in 4 cases (14%), residual cholesteatoma in 8 ears (25%). In the osteosynthesis group, successful reconstruction was achieved in 25 patients (96%). In 3 out of 4 patients of the glass-ionomeric cement group (75%) excessive granulation tissue developed with extensive bony lysis. Temporary removal of the posterior auditory canal wall offers potential for the control of cholesteatoma. Our first results suggest that osteosynthesis allows for a good anatomical and functional reconstruction.

Postoperative Displacement of Deep Brain Stimulation Electrodes Related to Lead-Anchoring Technique

Displacement of deep brain stimulation (DBS) electrodes may occur after surgery, especially due to large subdural air collections, but other factors might contribute. To investigate factors potentially contributing to postoperative electrode displacement, in particular, different lead-anchoring techniques. We retrospectively analyzed 55 patients (106 electrodes) with Parkinson disease, dystonia, tremor, and obsessive-compulsive disorder in whom early postoperative and long-term follow-up computed tomography (CT) was performed. Electrodes were anchored with a titanium microplate or with a commercially available plastic cap system. Two independent examiners determined the stereotactic coordinates of the deepest DBS contact on early postoperative and long-term follow-up CT. The influence of age, surgery duration, subdural air volume, use of microrecordings, fixation method, follow-up time, and side operated on first was assessed. Subdural air collections measured on average 4.3 ± 6.2 cm. Three-dimensional (3-D) electrode displacement and displacement in the X, Y, and Z axes significantly correlated only with the anchoring method, with larger displacement for microplate-anchored electrodes. The average 3-D displacement for microplate-anchored electrodes was 2.3 ± 2.0 mm vs 1.5 ± 0.6 mm for electrodes anchored with the plastic cap (P = .030). Fifty percent of the microplate-anchored electrodes showed 2-mm or greater (potentially relevant) 3-D displacement vs only 25% of the plastic cap-anchored electrodes (P < .01). The commercially available plastic cap system is more efficient in preventing postoperative DBS electrode displacement than titanium microplates. A reliability analysis of the electrode fixation is warranted when alternative anchoring methods are used.

Deep brain stimulation lead fixation after Stimloc failure

We report a method for deep brain stimulation (DBS) lead fixation in the event that the primary anchoring device fails to function effectively. The method involves the application of a titanium microplate to secure the lead to the skull, thereby providing a fast and reliable “rescue” mechanism for lead fixation. This method can supplement any burr hole cap and fixation method. Furthermore, this method has several advantages over removal and replacement of the primary anchor, such as a lower possibility of lead migration, faster procedural time, and cost-effectiveness.