Original Article

Comparison of a novel adhesive system and plate and screw for facial fracture osteosynthesis

Abstract

Background: In oral and maxillofacial fractures, plates and screws routinely fix fragments until the completion of healing process, which has its own complications in some critical fractures. To overcome this drawbacks bone adhesives are developed for the immobilization of fractured bones. Objective: In this in-vitro study we compared the bond strength obtained by immobilization of the bone fragments using plates and screw and new adhesive containing BTDMA monomer. Materials and Methods: In this experimental in-vitro trial, bone fractures were simulated in bovine’s mandibular bone using an electrical saw. The bone fragments were randomly allocated in different groups and were immobilized with either plate and screws and adhesive containing 0, 10, 15% BTDMA. After 24 hours tensile bond strength was calculated using universal testing machine. One-way ANOVA and Tukey post hoe test were used for statistical analysis. Results: Mean (±standard deviation) of tensile bond strength of bone fixation using adhesive containing 15% (W/W) BTDMA monomer were 176.0 (±18.89) N. These values were 149.1 (±23.88) N for adhesive containing 10% BTDMA; 102 (±17.99) N for the base adhesive and 278.9 (±24.12) N for the screw and plate technique. Significant differences were found regarding bond strength of bone fixation in 4 groups using bone adhesives or plate technique (P<0.001). The highest bond strength was recorded for the plate group and the least was related to the base adhesive. Significant differences existed between all bone adhesives as declared by paired comparison (p<0.05).Conclusion: Despite the lower bond strength in adhesive groups in comparison with screw and plate, with regards to possible complications of screw and plate technique, it seems bone adhesives containing BTDMA monomer can be used for bone fragment fixation. However, bond strength is just one of the numerous properties that an adhesive should have and more studies must be done on these kinds of adhesives.      
[1] Ioannides C, Freihofer HPM, Bruaset I. Trauma of the upper third of the face: management and follow-up. Journal of maxillofacial surgery. 1984;12:255-61.
[2] Zachariades N, Papademetriou I, Rallis G. Complications associated with rigid internal fixation of facial bone fractures. Journal of oral and maxillofacial surgery. 1993; 51(3):275-8.
[3] Maurer P, Bekes K, Gernhardt CR, Schaller HG, Schubert J. Comparison of the bond strength of selected adhesive dental systems to cortical bone under in vitro conditions. International journal of oral and maxillofacial surgery. 2004; 33(4):377-81.
[4] Smeets R, Marx R, Kolk A, Said-Yekta S, Grosjean MB, Stoll C, et al. In vitro study of adhesive polymethylmethacrylate
bone cement bonding to cortical bone in maxillofacial surgery. Journal of Oral and Maxillofacial Surgery. 68(12):3028-33.
[5] Salata LA, Mariguela VC, Antunes AA, Grossi-Oliveira G, Almeida A, Taba M. Short-term evaluation of grafts fixed with either N-butyl-2-cyanocrylate or screws. Journal of Oral and Maxillofacial Surgery. 72(4):676-82.
[6] Bayat M, Shojaei S, Bahrami N. 2017. Protein engineering of recombinant human bone morphogenetic protein 2 with higher interaction with Caphosphate based scaffold used for osteogenesis. J Biomed Mater Res Part A. 015:00A:000–000.
[7] Quintino L, Pires I. Overview of the technology of adhesive bonding in medical applications. Businessbriefing: Medical device manufacturing &Technology. 2004.
[8] Amarante MTJ, Constantinescu MA, O’Connor D,Yaremchuk MJ. Cyanoacrylate fixation of the craniofacialskeleton: an experimental study. Plastic and reconstructive surgery. 1995; 95(4):639-46.
[9] Shermak MA, Wong L, Inoue N, Crain BJ, Im MJ, Chao EYS, et al. Fixation of the craniofacial skeleton with butyl-2-cyanoacrylate and its effects on histotoxicity and healing. Plastic and reconstructive surgery. 1998; 102(2):309-18.
[10] Smeets R, Riediger D, Wirtz DC, Marx R, Endres K. Partially adhesive fixation of reconstruction plates at midfacial fractures– an alternative solution to screw fixation? Materialwissenschaft und Werkstofftechnik. 2007; 38(2):178-80.
[11] Endres K, Marx R, Tinschert J, Wirtz DC, Stoll C, Riediger D, et al. A new adhesive technique for internal fixation in midfacial surgery. Biomedical engineering online. 2008; 7(1):16.
[12] Perry MJ, Youngson CC. In vitro fracture fixation: dhesive systems compared with a conventional technique. British Journal of Oral and Maxillofacial Surgery. 1995; 33(4):224-7.
[13] Ho S, Nallathamby V, Ng H, Ho M, Wong M. A novel application of calcium phosphate-based bone cement as an adjunct procedure in adult craniofacial reconstruction. Craniomaxillofacial Trauma and Reconstruction. 4(04):235-40.
[14] Smeets R, Endres K, Stockbrink G, Hanken H, Hermanns†Sachweh B, Marx R, et al. The innovative application of a novel bone adhesive for facial fracture osteosynthesis— in vitro and in vivo results. Journal of Biomedical Materials Research Part A. 101(7):2058-66.
[15] Schortinghuis J, Bos RKM, Vissink A. Complications of internal fixation of maxillofacial fractures with microplates. Journal of oral and maxillofacial surgery. 1999; 57(2):130-4.
[16] Eppley BL, Sadove AM. Application of microfixation techniques in reconstructive maxillofacial surgery. Journal of oral and maxillofacial surgery.1991; 49(7):683-8.
[17] Heiss C, Hahn N, Wenisch S, Alt V, Pokinskyj P,Horas U, et al. The tissue response to an alkylene bis (dilactoyl)-methacrylate bone adhesive. Biomaterials.2005; 26(12):1389-96.
[18] Buckley MJ, Beckman EJ. Adhesive use in oral and maxillofacial surgery. Oral and maxillofacial surgeryclinics of North America. 22(1):195-9.
[19] Ghasaban S, Atai M, Imani M, Zandi M, Shokrgozar M. Photo†crosslinkable cyanoacrylate bioadhesive:
Shrinkage kinetics, dynamic mechanical properties, and biocompatibility of adhesives containing TMPTMA and POSS nanostructuresas crosslinking agents. Journal of Biomedical MaterialsResearch Part A. 99(2):240-8.
[20] Ghasaban S, Atai M, Imani M, Zandi M. Nanomechanical Properties of Photo-Cured Cyanoacrylate Bioadhesives Crosslinked by TMPTMA or POSS Nanostructures. Science and Technology.25(1):53-64.
[21] Arbes H, B sch P, Lintner F, Salzer M. First clinical experience with heterologous cancellous bone grafting combined with the fibrin adhesive system (FAS). Archives of orthopaedic and traumatic surgery.1981; 98(3):183-8.
[22] Summitt JB, Robbins JW, Hilton TJ, Schwartz RS.Fundamentals of operative dentistry: a contemporary approach. Quintessence Pub.; 2006.
[23] Atai M, Nekoomanesh M, Hashemi SA, Amani S.Physical and mechanical properties of an experimental dental composite based on a new monomer.Dental Materials. 2004; 20(7):663-8.
[24] Atai M, Nekoomanesh M, Hashemi SA, Yeganeh H. Synthesis and characterization of BTDAâ€based dimethacrylate dental adhesive monomer and its interaction with Ca2+ ions. Journal of applied polymer science. 2002; 86(13):3246-9.
[25] Maurer P, Bekes K, Gernhardt CR, Schaller H-Gn,Schubert J. Tensile bond strength of different adhesive systems between bone and composite compared:an in vitro study. Journal of Cranio-Maxillofacial Surgery. 2004; 32(2):85-9.
[26] Kandalam U, Bouvier AJ, Casas SB, Smith RL,Gallego AM, Rothrock JK, et al. Novel bone adhesives:a comparison of bond strengths in vitro.Int J Oral Maxillofac Surg 2013 Sep; 42(9):1054-9doi: 101016/jijom 201304005 Epub 2013 May 15
[27] Meechan JG, McCabe JF, Beynon AD. Adhesion of composite resin to bone—a pilot study. British Journal of Oral and Maxillofacial Surgery. 1994; 32(2):91-3.
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IssueVol 6, No 1 (Winter 2019) QRcode
SectionOriginal Article(s)
Published2019-08-24
DOI https://doi.org/10.18502/jcr.v6i1.1626
Keywords
Tensile bond strength Bone adhesives Maxillofacial fractures Plates and screws

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How to Cite
1.
Sharifi R, Atai M, Mohajeri M, Bahrami N. Comparison of a novel adhesive system and plate and screw for facial fracture osteosynthesis. J Craniomaxillofac Res. 2019;6(1):20-25.