Use of porous adhesive cement for fixation of fragments in fractures of the lower jaw

Abstract

BACKGROUND: The preferred method of treating mandibular fractures is surgical, but it also has problems due to a number of complications associated with the presence of a metal structure in the surgical wound.

AIM: To improve the efficiency of surgical treatment for mandibular fractures by developing and experimentally testing a method for fixing mandibular fragments using porous adhesive cement.

MATERIAL AND METHODS: The experiments were performed on 30 male Agouti guinea pigs, which were divided into two groups: the main group — 20 animals, the comparison group — 10 guinea pigs. A mandible fracture was modeled in all animals. In the main group, the fragments were fixed with porous glue-cement “Rekost”, in the comparison group — with a bone wire suture. All animals received prophylactic antibacterial therapy. All manipulations were performed under combined anesthesia. The statistical significance of the differences in the compared groups was assessed using Fisher's criterion. For all comparisons, the selected level of statistical significance was 5% (p ≤0.05).

RESULTS: The use of the method developed by us for fixation of bone fragments in mandible fractures allowed us to achieve a positive result in all 20 laboratory animals included in the study. This was confirmed by the results of histological studies in the dynamics of observation: a reliable difference was established between the main group and the comparison group in the severity of inflammation signs on the 14th day, as well as the severity of regeneration signs. It was found that the use of porous glue-cement for fixation of mandible fragments, in contrast to bone wire suture, allows for reliable consolidation of bone fragments for the entire period of treatment (according to X-ray diagnostic data) and to stop by the 14th day (according to histological studies) signs of inflammation in the bone wound (no leukocyte infiltration and vascular congestion). In this case, the glue allows filling the fusion area with developing bone tissue by the 90th day of observation (according to histological studies) and excluding repeated surgical intervention to remove the fixing structure, since the porous adhesive cement, according to histological studies, was absorbed by the 90th day of observation, which indicates its biodegradable properties.

CONCLUSION: The use of porous adhesive cement for fixation of mandibular fragments demonstrated better properties compared to bone wire suture.

Keywords

mandibular fracture / immobilization of fragments / porous adhesive cement

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