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HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin

Year 2014, Volume: 48 Issue: 1, 9 - 18, 08.04.2014

Abstract

Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerinin Histopatolojik Olarak incelenmesi

ABSTRACT
Purpose: Titanium and poly-L-lactide (PLLA) materials are frequently used in oral and orthopedic surgery in order to maintain stabilization and fixation. Complications such as cold sensitivity, radiologic artefacts, corrosion, allergic reactions and stress shielding that can be observed with titanium plates and/or screws may be prevented by using alternative materials such as PLLA substances. The aim of this study was to evaluate the histopathologic findings of the titanium and PLLA fixation screws on bone healing for autogenous graft fixation.
Materials and Methods: The study was performed on twenty-four New Zealand white rabbits. The effects of the titanium and PLLA materials on bone formation was compared with the control group. The animals were sacrified at the 6th weeks following the operation and the samples were evaluated histopathologically.
Results: The new bone formation area was found as between %5-30 in the 12.5% of the control group; %30-60 in the 6.3% of the PLLA group, 12.5% of the titanium group and 25% of the control group. 93.8% of the PLLA group, 87.5% of the titanium group and 43.8 of the control group showed greater new bone formation than 60% (p=0.019).
Conclusion: Resorbable fixation materials showed enough resistance in stability of the autogenous bone grafts. These materials did not present any the risk of the formation of the inflammation, necrosis and fibrosis. No statistically significant difference was observed regarding the new bone formation between the resorbable fixation materials and the titanium fixation materials.
Keywords: Bio-resorbable plates and screws, Poly-l-lactide, autogenous bone
ÖZ
Amaç: Titanyum ve PLLA (poli-L laktik asit) materyaller oral cerrahide ve ortopedik cerrahide stabilizasyon ve fiksasyon amacıyla sıklıkla kullanılmaktadır. Titanyum plak ve vidalarla birlikte soğuk hassasiyeti, radyolojik artefakt, korozyon, allerjik reaksiyonlar ve stres dağılımının sağlanamaması gibi komplikasyonların görülmesi araştırmacıları yeni seçenekler için çalışmaya itmiştir. PLLA materyaller bu komplikasyonların önlenmesinde alternatif olarak sunulan materyallerdir. Bu çalışmada maksillofasiyal cerrahide otojen onley kemik greftlerinin fiksasyonunda kullanılan titanyum ve PLLA fiksasyon vidalarının kemik iyileşmesine etkilerinin histopatolojik olarak incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmamız 24 adet Yeni Zelanda tavşanı üzerinde gerçekleştirilmiş, titanyum ve PLLA materyallerin kemik iyileşmesi üzerine etkileri kontrol grubu ile karşılaştırmalı olarak incelenmiştir. Deney hayvanları 6. haftada sakrifiye edilmiş ve elde edilen örnekler histopatolojik açıdan değerlendirilmiştir.
Bulgular: Yeni kemik yapımı alanı kontrol grubundaki kesitlerin %12.5'inde %5-30 oranında; PLLA grubunun %6.3'ünde, titanyum grubunun %12.5'inde ve kontrol grubunun ise %25'inde %30 - %60 oranında; PLLA grubunun %93.8'inde, titanyum grubunun %87.5' inde ve kontrol grubunun %43.8'inde ise %60'dan fazla olarak gözlenmiştir (p=0.019).
Sonuç: Rezorbe olabilen fiksasyon materyallerinin otojen kemik greftlerinin stabilizasyonunda yeterli direnci gösterdiklerini, bu materyallerin kullanımlarının enflamasyon, nekroz ve fibrozis oluşumu riskini arttırmadığını ve titanyum fiksasyon materyalleri ile aralarında kemik yapım oranları açısından anlamlı farklılık olmadığını saptadık.
Anahtar kelimeler: Rezorbe olabilen plak ve vidalar, Poly-l-laktid, otojen kemik

References

  • Narang R, Wells H. Stimulation of new bone formation on intact bones by decalsified allogeneic bone matrix. Oral Surg Oral Med Oral Pathol 1971;32(4):668-76. Elsalanty ME, Genecov DG. Bone graft substitute: a review of literature. Bone grafts in Craniofacial Surgery. Craniomaxillofac Trauma Reconstr 2009;2(3):125–34. Eppley BL, Sadove AM. A comparison of resorbable and metallic fixation in healing of calvarial bone grafts. Plast Reconstr Surg 1995;96(2):316-22. Chacon GE, Ellis JP, Kalmar JR, McGlumphy EA. Using resorbable screws for fixation of cortical onlay bone grafts: an in vivo study in rabbits. J Oral Maxillofac Surg 2004;62:1396-402. Sanger C, Soto A, Mussa F, Sanzo M, Sardo L, Donati PA, Di Pietro G, Spacca B, Giordano F, Genitori L. Maximizing results in craniofacial surgery with bioresorbable fixation devices. J Craniofac Surg 2007;18(4):926-30. Bergsma JE, de Bruijn WC, Rozema FR, Bos RR, Boering G. Late degradation tissue response to poly(L-lactide) bone plates ans screws. Biomaterials 1995;16(1):25-31. Coelho RC, Zerbinati LP, de Oliveira
  • MG, Weber JB. Systemic effects of LLLT on bone repair around PLLA-PGA screws in the rabbit tibia. Lasers Med Sci 2013;
  • Jul [Epub ahead of print] Magaña FG, Arzac RM, De Hilario Avilés L. Combined use of titanium mesh and resorbable PLLA-PGA implant in the treatment of large orbital floor fractures. J Craniofac Surg 2011;22(6):1991-5. Bhatt K, Roychoudhury A, Bhutia O, Trikha A, Seith A, Pandey RM. Equivalence randomized controlled trial of bioresorbable versus titanium miniplates in treatment of mandibular fracture: a pilot study. J Oral Maxillofac Surg 2010; 68(8):1842-8. Fedorowicz Z, Nasser M, Newton
  • JT, Oliver RJ. Resorbable versus titanium plates for orthognathic surgery. Cochrane Database Syst Rev 2007;18(2):CD006204. Eppley BL. Bioabsorbable plate and screw fixation in orthognathic surgery. J
  • Craniofac Surg 2007;18(4):818-25. Mazzonetto R, Paza AO, Spagnoli
  • DB. A retrospective evaluation of rigid fixation in orthognathic surgery using a biodegradable self-reinforced (70L:30DL) polyactide. Int J Oral Maxillofac Surg 2004;33(7):664–9. Cheung LK, Chow LK, Chiu WK. A randomized controlled trial of resorbable versus titanium fixation for orthognathic surgery. Oral Surg Oral Med Oral Pathol
  • Oral Radiol Endod 2004;98(4):386-97. Edwards RC, Kiely KD, Eppley BL. Resorbable fixation techniques for genioplasty. J Oral Maxillofac Surg 2000;58(3):269-72. Laughlin RM, Block MS, Wilk R, Malloy RB, Kent JN. Resorbable plates for the fixation of mandibular fractures: a prospective study. J Oral Maxillofac Surg 2007;65(1):89-96.
  • Landes CA, Ballon A. Indications and limitations in resorbable P(L70/30DL) LA osteosyntheses of displaced mandibular fractures in 4.5-year follow-up. Plast Reconstr Surg 2006;117(2):577-87.
  • Bell RB, Kindsfater CS. The use of biodegradable plates and screws to stabilize facial fractures. J Oral Maxillofac Surg 2006;64(1):31-9.
  • Bergsma EJ, Rozema FR, Bos RR, de Bruijn WC. Foreign body reactions to resorbable poly(L-lactide) bone plates and screws used for the fixation of unstablezygomatic fractures. J Oral Maxillofac Surg 1993;51(6):666-70.
  • Weisberger EC, Eppley BL. Resorbable fixation plates in head and neck surgery. Laryngoscope 1997;107(6):716-9.
  • Suzuki T, Kawamura H, Kasahara T, Nagasaka H. Resorbable poly-L-lactide plates and screws for the treatment of mandibular condylar process fractures: a clinical and radiologic follow-up study. J Oral Maxillofac Surg 2004;62(8):919-24.
  • Eppley BL, Morales L, Wood R, Pensler J, Goldstein J, Havlik RJ, Habal M, Losken A, Williams JK, Burstein F, Rozzelle AA, Sadove AM. Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1883 patients . Plast Reconstr Surg 2004;114(4):850-6; discussion 857.
  • Eppley BL. Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg 2005;63(3):385-91.
  • Imola MJ, Hamlar DD, Shao W, Chowdhury K, Tatum S. Resorbable plate fixation in pediatric craniofacial surgery: long-term outcome. Arch Facial Plast Surg 2001;3(2):79-90.
  • Imola MJ, Schramm VL. Resorbable internal fixation in pediatric cranial base surgery. Laryngoscope 2002;112(10):189790 Eppley BL, Sadove AM, Havlik
  • RJ. Resorbable plate fixation in pediatric craniofacial surgery. Plast Reconstr Surg 1997;100(1):1-7; discussion 8-13. Corresponding Author: Cemil İŞLER Istanbul University Faculty of Dentistry Department of Oral and Maxillofacial Surgery 34390, Fatih-Istanbul / Turkey Phone: (0212) 3414 20 20 (30289) e-mail: dtcemil@yahoo.com

Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik İyileşmesine Etkilerinin Histopatolojik Olarak İncelenmesi

Year 2014, Volume: 48 Issue: 1, 9 - 18, 08.04.2014

Abstract

Amaç: Titanyum ve PLLA (poli-L laktik asit) materyaller oral cerrahide ve ortopedik cerrahide stabilizasyon ve fiksasyon amacıyla sıklıkla kullanılmaktadır. Titanyum plak ve vidalarla birlikte soğuk hassasiyeti, radyolojik artefakt, korozyon, allerjik reaksiyonlar ve stres dağılımının sağlanamaması gibi komplikasyonların görülmesi araştırmacıları yeni seçenekler için çalışmaya itmiştir. PLLA materyaller bu komplikasyonların önlenmesinde alternatif olarak sunulan materyallerdir. Bu çalışmada maksillofasiyal cerrahide otojen onley kemik greftlerinin fiksasyonunda kullanılan titanyum ve PLLA fiksasyon vidalarının kemik iyileşmesine etkilerinin histopatolojik olarak incelenmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmamız 24 adet Yeni Zelanda tavşanı üzerinde gerçekleştirilmiş, titanyum ve PLLA materyallerin kemik iyileşmesi üzerine etkileri kontrol grubu ile karşılaştırmalı olarak incelenmiştir. Deney hayvanları 6. haftada sakrifiye edilmiş ve elde edilen örnekler histopatolojik açıdan değerlendirilmiştir.Bulgular: Yeni kemik yapımı alanı kontrol grubundaki kesitlerin %12.5’inde %5-30 oranında; PLLA grubunun %6.3’ünde, titanyum grubunun %12.5’inde ve kontrol grubunun ise %25’inde %30 - %60 oranında; PLLA grubunun %93.8’inde, titanyum grubunun %87.5’ inde ve kontrol grubunun %43.8’inde ise %60’dan fazla olarak gözlenmiştir (p=0.019).Sonuç: Rezorbe olabilen fiksasyon materyallerinin otojen kemik greftlerinin stabilizasyonunda yeterli direnci gösterdiklerini, bu materyallerin kullanımlarının enflamasyon, nekroz ve fibrozis oluşumu riskini arttırmadığını ve titanyum fiksasyon materyalleri ile aralarında kemik yapım oranları açısından anlamlı farklılık olmadığını saptadık.

References

  • Narang R, Wells H. Stimulation of new bone formation on intact bones by decalsified allogeneic bone matrix. Oral Surg Oral Med Oral Pathol 1971;32(4):668-76. Elsalanty ME, Genecov DG. Bone graft substitute: a review of literature. Bone grafts in Craniofacial Surgery. Craniomaxillofac Trauma Reconstr 2009;2(3):125–34. Eppley BL, Sadove AM. A comparison of resorbable and metallic fixation in healing of calvarial bone grafts. Plast Reconstr Surg 1995;96(2):316-22. Chacon GE, Ellis JP, Kalmar JR, McGlumphy EA. Using resorbable screws for fixation of cortical onlay bone grafts: an in vivo study in rabbits. J Oral Maxillofac Surg 2004;62:1396-402. Sanger C, Soto A, Mussa F, Sanzo M, Sardo L, Donati PA, Di Pietro G, Spacca B, Giordano F, Genitori L. Maximizing results in craniofacial surgery with bioresorbable fixation devices. J Craniofac Surg 2007;18(4):926-30. Bergsma JE, de Bruijn WC, Rozema FR, Bos RR, Boering G. Late degradation tissue response to poly(L-lactide) bone plates ans screws. Biomaterials 1995;16(1):25-31. Coelho RC, Zerbinati LP, de Oliveira
  • MG, Weber JB. Systemic effects of LLLT on bone repair around PLLA-PGA screws in the rabbit tibia. Lasers Med Sci 2013;
  • Jul [Epub ahead of print] Magaña FG, Arzac RM, De Hilario Avilés L. Combined use of titanium mesh and resorbable PLLA-PGA implant in the treatment of large orbital floor fractures. J Craniofac Surg 2011;22(6):1991-5. Bhatt K, Roychoudhury A, Bhutia O, Trikha A, Seith A, Pandey RM. Equivalence randomized controlled trial of bioresorbable versus titanium miniplates in treatment of mandibular fracture: a pilot study. J Oral Maxillofac Surg 2010; 68(8):1842-8. Fedorowicz Z, Nasser M, Newton
  • JT, Oliver RJ. Resorbable versus titanium plates for orthognathic surgery. Cochrane Database Syst Rev 2007;18(2):CD006204. Eppley BL. Bioabsorbable plate and screw fixation in orthognathic surgery. J
  • Craniofac Surg 2007;18(4):818-25. Mazzonetto R, Paza AO, Spagnoli
  • DB. A retrospective evaluation of rigid fixation in orthognathic surgery using a biodegradable self-reinforced (70L:30DL) polyactide. Int J Oral Maxillofac Surg 2004;33(7):664–9. Cheung LK, Chow LK, Chiu WK. A randomized controlled trial of resorbable versus titanium fixation for orthognathic surgery. Oral Surg Oral Med Oral Pathol
  • Oral Radiol Endod 2004;98(4):386-97. Edwards RC, Kiely KD, Eppley BL. Resorbable fixation techniques for genioplasty. J Oral Maxillofac Surg 2000;58(3):269-72. Laughlin RM, Block MS, Wilk R, Malloy RB, Kent JN. Resorbable plates for the fixation of mandibular fractures: a prospective study. J Oral Maxillofac Surg 2007;65(1):89-96.
  • Landes CA, Ballon A. Indications and limitations in resorbable P(L70/30DL) LA osteosyntheses of displaced mandibular fractures in 4.5-year follow-up. Plast Reconstr Surg 2006;117(2):577-87.
  • Bell RB, Kindsfater CS. The use of biodegradable plates and screws to stabilize facial fractures. J Oral Maxillofac Surg 2006;64(1):31-9.
  • Bergsma EJ, Rozema FR, Bos RR, de Bruijn WC. Foreign body reactions to resorbable poly(L-lactide) bone plates and screws used for the fixation of unstablezygomatic fractures. J Oral Maxillofac Surg 1993;51(6):666-70.
  • Weisberger EC, Eppley BL. Resorbable fixation plates in head and neck surgery. Laryngoscope 1997;107(6):716-9.
  • Suzuki T, Kawamura H, Kasahara T, Nagasaka H. Resorbable poly-L-lactide plates and screws for the treatment of mandibular condylar process fractures: a clinical and radiologic follow-up study. J Oral Maxillofac Surg 2004;62(8):919-24.
  • Eppley BL, Morales L, Wood R, Pensler J, Goldstein J, Havlik RJ, Habal M, Losken A, Williams JK, Burstein F, Rozzelle AA, Sadove AM. Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1883 patients . Plast Reconstr Surg 2004;114(4):850-6; discussion 857.
  • Eppley BL. Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg 2005;63(3):385-91.
  • Imola MJ, Hamlar DD, Shao W, Chowdhury K, Tatum S. Resorbable plate fixation in pediatric craniofacial surgery: long-term outcome. Arch Facial Plast Surg 2001;3(2):79-90.
  • Imola MJ, Schramm VL. Resorbable internal fixation in pediatric cranial base surgery. Laryngoscope 2002;112(10):189790 Eppley BL, Sadove AM, Havlik
  • RJ. Resorbable plate fixation in pediatric craniofacial surgery. Plast Reconstr Surg 1997;100(1):1-7; discussion 8-13. Corresponding Author: Cemil İŞLER Istanbul University Faculty of Dentistry Department of Oral and Maxillofacial Surgery 34390, Fatih-Istanbul / Turkey Phone: (0212) 3414 20 20 (30289) e-mail: dtcemil@yahoo.com
There are 17 citations in total.

Details

Primary Language English
Journal Section Original Research Articles
Authors

Sabri İşler This is me

Zerrin Çebi This is me

Publication Date April 8, 2014
Published in Issue Year 2014 Volume: 48 Issue: 1

Cite

APA İşler, S., & Çebi, Z. (2014). HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin. Journal of Istanbul University Faculty of Dentistry, 48(1), 9-18.
AMA İşler S, Çebi Z. HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin. J Istanbul Univ Fac Dent. April 2014;48(1):9-18.
Chicago İşler, Sabri, and Zerrin Çebi. “HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar Ile Titanyum Vidaların Kemik iyileşmesine Etkilerin”. Journal of Istanbul University Faculty of Dentistry 48, no. 1 (April 2014): 9-18.
EndNote İşler S, Çebi Z (April 1, 2014) HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin. Journal of Istanbul University Faculty of Dentistry 48 1 9–18.
IEEE S. İşler and Z. Çebi, “HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin”, J Istanbul Univ Fac Dent, vol. 48, no. 1, pp. 9–18, 2014.
ISNAD İşler, Sabri - Çebi, Zerrin. “HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar Ile Titanyum Vidaların Kemik iyileşmesine Etkilerin”. Journal of Istanbul University Faculty of Dentistry 48/1 (April 2014), 9-18.
JAMA İşler S, Çebi Z. HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin. J Istanbul Univ Fac Dent. 2014;48:9–18.
MLA İşler, Sabri and Zerrin Çebi. “HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar Ile Titanyum Vidaların Kemik iyileşmesine Etkilerin”. Journal of Istanbul University Faculty of Dentistry, vol. 48, no. 1, 2014, pp. 9-18.
Vancouver İşler S, Çebi Z. HISTOPATHOLOGICAL EXAMINATION OF THE EFFECTS OF THE RESORBABLE AND TITANIUM SCREWS WHICH USED IN AUTOGENOUS BONE GRAFT ON BONE HEALING Otojen Kemik Greft Fiksasyonunda Kullanılan Rezorbe Olabilen Vidalar ile Titanyum Vidaların Kemik iyileşmesine Etkilerin. J Istanbul Univ Fac Dent. 2014;48(1):9-18.