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Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis
Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysi...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756660/ https://www.ncbi.nlm.nih.gov/pubmed/31592391 http://dx.doi.org/10.1097/GOX.0000000000002384 |
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author | Chocron, Yehuda Azzi, Alain J. Cugno, Sabrina |
author_facet | Chocron, Yehuda Azzi, Alain J. Cugno, Sabrina |
author_sort | Chocron, Yehuda |
collection | PubMed |
description | Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysis is to shed light on overall outcomes for resorbable implants and to compare these results to those for metallic counterparts. METHODS: A systematic review of clinical studies reporting outcomes for resorbable plates for mandible fractures was carried out. The reported outcomes were hardware failure/exposure, infection, wound dehiscence, reoperation, malocclusion, and nonunion. The results were pooled descriptively and stratified according to fracture and implant type. A subset meta-analysis of prospective studies comparing metallic and resorbable implants was also carried out. RESULTS: Eighteen studies were included for a total of 455 patients managed with resorbable implants (mean follow-up, 8.95 months) with an overall complication rate of 19.8 % (n = 90/455). Infection (n = 31/455, 6.8%) and wound dehiscence (n = 28/455, 6.2%) were the most common complications. Nonunion occurred in 1.1% (n = 5/455) of patients. Seven studies were included in a meta-analysis, and the rates of adverse events in the resorbable and metallic groups were 18.0% (n = 32/178) and 18.3% (n = 33/180), respectively, with no statistically significant difference between both cohorts (95% CI 0.58, 1.82, P = 0.93). CONCLUSIONS: This study suggests that there are no statistical differences in outcomes for patients with mandible fractures managed with resorbable or metallic implants. In the absence of meta-analyses or large randomized controlled trials, the current study provides surgeons with an evidence-based reference to guide decision-making. |
format | Online Article Text |
id | pubmed-6756660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67566602019-10-07 Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis Chocron, Yehuda Azzi, Alain J. Cugno, Sabrina Plast Reconstr Surg Glob Open Original Article Mandibular fractures in adults commonly require rigid fixation to ensure proper occlusion while minimizing infection risks. Numerous centers have assessed the efficacy of resorbable materials as a potential alternative to metallic plates. The purpose of the current systematic review and meta-analysis is to shed light on overall outcomes for resorbable implants and to compare these results to those for metallic counterparts. METHODS: A systematic review of clinical studies reporting outcomes for resorbable plates for mandible fractures was carried out. The reported outcomes were hardware failure/exposure, infection, wound dehiscence, reoperation, malocclusion, and nonunion. The results were pooled descriptively and stratified according to fracture and implant type. A subset meta-analysis of prospective studies comparing metallic and resorbable implants was also carried out. RESULTS: Eighteen studies were included for a total of 455 patients managed with resorbable implants (mean follow-up, 8.95 months) with an overall complication rate of 19.8 % (n = 90/455). Infection (n = 31/455, 6.8%) and wound dehiscence (n = 28/455, 6.2%) were the most common complications. Nonunion occurred in 1.1% (n = 5/455) of patients. Seven studies were included in a meta-analysis, and the rates of adverse events in the resorbable and metallic groups were 18.0% (n = 32/178) and 18.3% (n = 33/180), respectively, with no statistically significant difference between both cohorts (95% CI 0.58, 1.82, P = 0.93). CONCLUSIONS: This study suggests that there are no statistical differences in outcomes for patients with mandible fractures managed with resorbable or metallic implants. In the absence of meta-analyses or large randomized controlled trials, the current study provides surgeons with an evidence-based reference to guide decision-making. Wolters Kluwer Health 2019-08-30 /pmc/articles/PMC6756660/ /pubmed/31592391 http://dx.doi.org/10.1097/GOX.0000000000002384 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Chocron, Yehuda Azzi, Alain J. Cugno, Sabrina Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title | Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title_full | Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title_fullStr | Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title_short | Resorbable Implants for Mandibular Fracture Fixation: A Systematic Review and Meta-Analysis |
title_sort | resorbable implants for mandibular fracture fixation: a systematic review and meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756660/ https://www.ncbi.nlm.nih.gov/pubmed/31592391 http://dx.doi.org/10.1097/GOX.0000000000002384 |
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