Background: Internal fixation of mandibular fractures with Titanium (Ti) plates has become the gold standard for treatment in the adult population. Unfortunately, Ti plates had a tendency to undergo corrosion causing inflammation of surrounding bone that often led to failure of treatment. Magnesium (Mg) based newer materials such as WE43 alloy have been studied extensively for its ability to resorb in the presence of living tissue. Mg based WE43 alloy has demonstrated superior corrosion resistance and mechanical properties comparable to standard Titanium devices. The aim of this systematic review was to know whether WE43 based fixation devices can be used as an alternative to Ti based fixation devices for osteosynthesis. Materials and Methods: PubMed, Cochrane, Google Scholar, Web of Science, were searched to find the studies comparing the WE43 fixation devices and Ti based fixation devices for osteosynthesis. No filters were applied. Search terms related to WE43, titanium, fixation, osteosynthesis, corrosion resistance, fracture fixation, complications of treatment, etc, were used to search relevant studies. Data extraction, quality assessment, and summary synthesis for treatment outcomes including corrosion resistance,stability, osteosynthesis, adverse effects were carried out. Results: 5 studies consisting of 3 in-vivo animal studies and 2 clinical trials were included after the screening of search results. In the animal studies, i)16 rabbit specimens were divided into 2 groups -Group I received Ti based implants, while Group II received Mg based WE43 implants. ii)10 beagle dogs were divided into 2 groups and evaluated at 4, 12, and 24 weeks after implant placement. iii)18 hemi mandibles of sheep were tested to check the outcome of fracture fixation between Mg and Ti based fixation devices. Group I used Ti1.0, Group II used Mg 1.75, and Group III used Mg 1.5. In the clinical trials, i) fixation of mandibular head fracture was done in 31 using WE43 screws and 29 patients using Mg screws and ii) 11 patients treated with Mg compression screws and 10 patients with Ti compression screws. Conclusions: Comparison of properties of WE43 with Ti in the animal models has shown a non-inferiority of the Mg based material. Biomechanically, the human studies revealed promising results concerning the use of WE43 as a potential alternative to Ti in fracture fixation. Further evaluation is warranted under biomechanical loading conditions to verify the clinical performance of the material.
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