Applications of Biodegradable Magnesium-Based Materials in Reconstructive Oral and Maxillofacial Surgery: A Review
Abstract
:1. Introduction
2. Biological Properties of Mg-Based Materials
3. Bioresorbable Mg-Based Materials for Guided Bone Regeneration (GBR)
3.1. GBR Membranes
3.2. Mg-Based Scaffolds for GBR
4. Mg and Mg-Based Materials for Ti Implant Coating
5. Bioresorbable Mg-Based Materials for Osteosynthesis of the Facial Bone Fractures
6. Mg-Based Materials for Soft Tissue Regeneration
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Reference | Study | Materials | Fixation Type | Methodology | Evaluation | Results |
---|---|---|---|---|---|---|
Lee et al. [100] | Finite element modeling | Mg (pure) Polymer Ti | Screw | Bilateral mandibular ramus sagittal split osteotomy | Stress distribution | Mg screws maintained stability at osteotomy sites superior to the polymer material |
Lee et al. [101] | Finite element modeling | Mg-Ca-Zn alloy Polymer Ti | Screw | Bilateral mandibular ramus sagittal split osteotomy | Stress distribution | Mg-Ca-Zn screws maintained stability at osteotomy sites and displayed masticatory loading superior to the polymer material |
Schaller et al. [102] | Animal experiment (minipigs) | WE43 alloy | Rivet | Implantation on mandibular angle | Histology Micro-CT | Sufficient stability of the rivets during 12–24 weeks |
Naujokat et al. [103] | Animal experiment (minipigs) | WE43 alloy | Plate + screws | Unicortical osteotomy at mandibular angle | Histology Micro-CT | Sufficient stability of the plates and screws for 8 weeks, no side effects |
Henderson et al. [99] | Animal experiment (rabbits) | Mg AZ31 alloy Stainless steel | Screw | Implantation on mandibular angle | Histology Micro-CT | Sufficient stability of the screws, physiological bone remodeling |
Byun et al. [104] | Animal experiment (beagles) | WE43 Ti | Plate + screws | Le Fort I osteotomy of the maxilla | Histology Micro-CT | Sufficient stability of the plates and screws for 24 weeks; significant gas formation in the first 12 weeks |
Byun et al. [105] | Animal experiment (beagles) | ZK60 coated with PLLA | Plate + screws | Le Fort I osteotomy of the maxilla | Micro-CT | Rapid biodegradation of ZK60 resulted in insufficient results |
Schaller et al. [106] | Animal experiment (minipigs) | WE43 Polymer (PLGA) | Plate + screws | Osteotomy at supraorbital rim and zygomatic arch | Histology Micro-CT | Sufficient stability of the plates and screws in the midface region |
Kim et al. [107] | Animal experiment (beagles) | WE43 polymer | Plate + screws | Osteotomy at zygomatic arch | Histology Micro-CT | Sufficient stability, biocompatibility and osteogenic activity of the plates and screws in the midface region |
Naujokat et al. [108] | Animal experiment (minipigs) | WE43 Ti | Plate + screws | Frontal bone osteotomy | Histology Micro-CT | WE43 sufficient stability of the plates and screws in the calvaria compared to Ti |
Schaller et al. [109] | Animal experiment (minipigs) | WE43 Ti | Plate + screws | Frontal bone osteotomy | Histology Micro-CT | WE43 sufficient stability of the plates and screws in the calvaria compared to Ti |
Zhang et al. [110] | Animal experiment (canines) | Ca-P coated Mg-Zn-Gd scaffold Ti | Mesh | Defect of the medial orbital wall | Histology Micro-CT | Ca-P coated Mg-Zn-Gd scaffold resulted in excellent bone regeneration, no gas formation |
Reference | Study | Fracture Pattern | N | Material | Results | Complications |
---|---|---|---|---|---|---|
Leonhardt et al. [111] | Case series | Displaced fractures of the condylar head with a loss of height on the mandibular ramus, and clinical signs such as pain, malocclusion, and jaw movement, limited excursions | 4 patients with unilateral fractures 1 patient with bilateral fracture | Magnezix® CS 2.7 mm screw (Syntellix AG, Hanover, Germany) | Stabilization of fracture, restored function of TMJ, no gass formation during 3 months | One accidental fracture of the screw which was replaced |
Leonhardt et al. [112] | Retrospective observational study | Displaced fractures of the condylar head with a loss of height on the mandibular ramus, and clinical signs such as pain, malocclusion, and jaw movement, limited excursions | 6 patients | Magnezix® CS 2.7 mm screw (Syntellix AG, Hanover, Germany) | Restoration of occlusion and function of TMJ, gas lacunas visible for 6 months afterwards filled with bone, partial resorption of screws in first year | none |
Application | Study | Advantages | Disadvantages | Future Directions | |||
---|---|---|---|---|---|---|---|
In vitro | In vivo | Clinical | |||||
Fracture reduction | Mandible fracture | + | + | + | -biocompatibility -degradation -elastic modulus -mechanical properties -no second stage surgery | -low resistance to masticatory stress | -improvement of mechanical resistance for load-bearing fractures -development of Mg alloys with predictive degradation rate |
Midface fracture | + | + | − | -uncontrolled degradation rate | |||
Frontal bone fracture | + | + | − | -uncontrolled degradation rate | |||
GBR | Scaffolds | + | + | + | -biocompatibility -osteoconductivity -bone repair | -low porosity | -improvement of 3D porosity |
Membrane | + | + | − | -biocompatibility -degradation-mechanical properties -osteogenic effect -small and large bone defects -antibacterial activity | -uncontrolled degradation rate | -improvement of mechanical properties and degradation rate | |
Oral implantology | + | + | − | -biocompatibility -degradation-osteoblastic differentiation -antibacterial activity | -degradation rate | -need for clinical trials -development of techniques for Mg coating | |
Soft tissue regeneration | TMJ | + | − | − | -protective effect on cartilage | -no data on TMJ regeneration | -no trials on the possible use on TMJ cartilage regeneration |
Dental pulp | + | − | − | -dental pulp repair | -no trials on the preclinical or clinical use | ||
Oral mucosa | + | − | − | -fibroblast activation -mucosa regeneration -antibacterial properties | -possible use in dental implantology | ||
Nerve tissue | + | + | − | -nerve regeneration | -possible use in sensitive nerve neuropathy |
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Vujović, S.; Desnica, J.; Stanišić, D.; Ognjanović, I.; Stevanovic, M.; Rosic, G. Applications of Biodegradable Magnesium-Based Materials in Reconstructive Oral and Maxillofacial Surgery: A Review. Molecules 2022, 27, 5529. https://doi.org/10.3390/molecules27175529
Vujović S, Desnica J, Stanišić D, Ognjanović I, Stevanovic M, Rosic G. Applications of Biodegradable Magnesium-Based Materials in Reconstructive Oral and Maxillofacial Surgery: A Review. Molecules. 2022; 27(17):5529. https://doi.org/10.3390/molecules27175529
Chicago/Turabian StyleVujović, Sanja, Jana Desnica, Dragana Stanišić, Irena Ognjanović, Momir Stevanovic, and Gvozden Rosic. 2022. "Applications of Biodegradable Magnesium-Based Materials in Reconstructive Oral and Maxillofacial Surgery: A Review" Molecules 27, no. 17: 5529. https://doi.org/10.3390/molecules27175529