Delayed inflammation after biodegradable and osteoconductive osteofixation in orthognathic surgery

• Published in: Journal of the Korean Association of Oral and Maxillofacial Surgeons Vol. 50; no. 6; pp. 350 - 355
• Main Author: Park, Young-Wook
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Oral and Maxillofacial Surgeons 31.12.2024; 대한구강악안면외과학회
• Subjects: Case Series Study; 치의학; Biodegradable osteofixation; Delayed inflammation; Foreign-body reaction
• ISSN: 2234-7550; 2234-5930
• DOI: 10.5125/jkaoms.2024.50.6.350

This study aims to identify patterns and to describe the clinical course of delayed adverse tissue responses in patients who underwent orthognathic osteotomy with biodegradable osteofixation. Through a retrospective review of cases between 2013 and 2020, we identified three patients who underwent bimaxillary osteotomy and fixation with unsintered-hydroxyapatite/poly-L lactic acid (u-HA/PLLA) devices, after which they developed delayed inflammation. These lesions were treated with drainage and/or removal of the devices. Histological evaluations were conducted using H&E staining, and structural changes in the u-HA/PLLA devices were assessed by scanning electron microscopy (SEM). Inflammatory lesions developed only in the mandible, with onset ranging from 12 to 35 months postoperation. Histological studies identified foreign-body granulomas or secondarily infected lesions. SEM analysis indicated biodegradation and tissue integration. Orthognathic patients treated using u-HA/PLLA devices should be informed about the potential for delayed inflammation and monitored for at least 3 years.