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Evidence summaries

Resorbable Versus Titanium Plates for Orthognathic Surgery

There may be no difference in postoperative discomfort, level of patient satisfaction, plate exposure or infection for plate and screw fixation using either titanium or resorbable materials in orthognathic surgery. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 2 studies with a total of 103 subjects. One compared titanium with resorbable plates and screws and the other titanium with resorbable screws, both provided very limited data for the primary outcomes of this review. All patients in one trial suffered mild to moderate postoperative discomfort with no statistically significant difference between the two plating groups at different follow-up times. Mean scores of patient satisfaction were 7.43 to 8.63 (range 0 to 10) with no statistically significant difference between the two groups throughout follow up. Adverse effects reported in one study were two plate exposures in each group occurring between the third and ninth months. Plate exposures occurred mainly in the posterior maxillary region, except for one titanium plate exposure in the mandibular premolar region. Known causes of infection were associated with loosened screws and wound dehiscence with no statistically significant difference in the infection rate between titanium (3/196), and resorbable (3/165) plates P = 0.83 (published as P = 0.67).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and by imprecise results) few studied patients.

    References

    • Fedorowicz Z, Nasser M, Newton JT, Oliver RJ. Resorbable versus titanium plates for orthognathic surgery. Cochrane Database Syst Rev 2007 Apr 18;(2):CD006204. [PubMed]

Primary/Secondary Keywords