Skeletal stability and morbidity with self-reinforced P (L/DL) LA resorbable osteosynthesis in bimaxillary orthognathic surgery

Introduction: We present a retrospective study of 30 consecutive cases of bimaxillary orthognathic surgery with biodegradable self-reinforced poly-L/DL-lactide plates and tacks, for the same indication of Angle class Ill malocclusion. We reported the skeletal stability and morbidity at 1 year after surgery. Patients and methods: All patients underwent bimaxillary procedure. We used self-reinforced poly-L/DL lactic acid copolymer. Stabilization of Lefort I osteotomy was achieved by four plates L-shaped. Sagittal split osteotomies were fixed by two straight-plates. Literal cephalograms were taken before (TO), soon after (T1) and more than 1 year after surgery (T2). Eight standard landmarks and four angular measurements were taken into account. All differences of the landmarks and angles were measured at T1 and T2. The regular clinical follow-up was scheduled for a minimum period of 1 year. Results: The mean advanced maxillary was 3.33 mm and the mean mandibular setback was 6.13 mm. The mean mandibular relapse was 2.2 mm (non-significant). Horizontal maxilla mean variation was 0.8 mm at 1 year at A-point. Vertical maxilla stability depends on maxillary movements: impaction stability is better as an isolated advancement or associated with pull-down movement. We found six inflammatory reactions and two of them need the removal of the plates. Conclusion: Bimaxillary orthognathic procedure with bioresorbable osteosynthesis is a reliable and reproducible method. Angle class HI malocclusions could be entirely and successfully managed with bioresorbable osteosynthesis. The stability and suites at 1 year are comparable to titanium osteosynthesis. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.