Metallic implants have been extensively used for osteofixation in craniomaxillofacial surgery (CMF). Although they are mainly inert, the disadvantage of not being resorbable remains. Advances in biomaterials technology led to the development of resorbable polymers composed by monomeric units that are naturally present in the body. Among them are polylactide (PLA), polyglycolide (PGA) and their copolymers (PLGA and P(L/DL)LA). After in-depth studies of the structure of these materials, the self-reinforced (SR) technology has merged to solve their mechanical limitations. SR is based on reinforcing elements within the same material, increasing their strength. Ultra-high strength implants were then manufactured by the SR technique. In CMF surgery, SR devices have been used for over 10 years without reported complications. As advantages, SR devices have shown to be biocompatible, reliable, easily handled, and to have favorable degradation properties. At present, copolymeric SR devices (P(L/DL)LA, BioSorb FX, and PLGA, BioSorb PDX) represent an advance in the clinical application of absorbable devices in CMF surgery. The aim of this review is to give an overall understanding of the ultimate advances in biomaterial research for CMF reconstruction, with emphasis in self-reinforced resorbable devices. We also intend to give insight into new devices, such as SR, tacks and their applicability.
European Journal of Plastic Surgery – Springer Journals
Published: Feb 1, 2004
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