国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (3): 381-387.doi: 10.7518/gjkq.2026105

• 综述 • 上一篇    

可吸收固定材料应用于髁突骨折的研究进展

赵筱格1(),吕坤2()   

  1. 1.口颌系统重建与再生全国重点实验室 口腔生物医学教育部重点实验室 口腔医学湖北省重点实验室 武汉大学口腔医（学）院 武汉 430079
    2.口颌系统重建与再生全国重点实验室 口腔生物医学教育部重点实验室 口腔医学湖北省重点实验室 武汉大学口腔医（学）院 武汉大学口腔医院口腔颌面创伤与颞下颌关节外科 武汉 430079
  • 收稿日期:2025-04-16 修回日期:2025-08-01 出版日期:2026-05-01 发布日期:2026-04-24
  • 通讯作者: 吕坤
  • 作者简介:赵筱格，硕士，Email：zhaoxiaoge@whu.edu.cn

Research and application progress of absorbable material for condylar fracture fixation

Xiaoge Zhao1(),Kun Lü2()   

  1. 1.State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
    2.State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2025-04-16 Revised:2025-08-01 Online:2026-05-01 Published:2026-04-24
  • Contact: Kun Lü

RichHTML

3

PDF (PC)

5

摘要：

目前临床髁突骨折开放复位内固定材料为钛合金及可吸收材料。钛合金固位及稳定性佳，但可能影响磁共振检查，通常需要二次取出。具有人体相容性的可吸收聚合物材料是基于能够被人体利用的可吸收单体合成的共聚物及其改性的衍生物，固位及稳定性可靠，如无特殊情况，一般不需要二次取出。随着科学技术的发展，出现了超声激活可吸收聚合物螺钉、可吸收镁基金属螺钉及可吸收生物陶瓷材料。这些可吸收材料都展现了足够的力学性能及临床疗效。本文就可吸收材料的类型、适应证、技术发展、临床应用及未来展望作一综述。

关键词: 髁突骨折, 内固定, 可吸收, 聚乳酸, 镁基金属

Abstract:

The materials currently used for the open reduction and internal fixation of condylar fractures in clinical practice are titanium alloys and absorbable materials. Titanium alloys have excellent retention and stability but may interfere with magnetic resonance imaging and usually require secondary removal. Biocompatible, absorbable polymers are copolymers synthesized from absorbable monomers and their modified derivatives and can be utilized by the human body. They provide reliable retention and stability and generally do not require secondary removal unless special circumstances arise. Advances in science and technology have led to the development of ultrasound-activated absorbable polymer screws, absorbable magnesium-based metal screws, and absorbable bioceramics. These absorbable materials have demonstrated sufficient mechanical properties and clinical efficacy. This work aims to review the types, indications, technological advancements, clinical applications, and future prospects of absorbable materials.

Key words: condylar fracture, internal fixation, absorbable, poly lactic acid, magnesium-based metal

中图分类号: 

  • R782.6
[1] Xia DD, Yang F, Zheng YF, et al. Research status of biodegradable metals designed for oral and maxillofacial applications: a review[J]. Bioact Mater, 2021, 6(11): 4186-4208.
[2] George SM, Nayak C, Singh I, et al. Multifunctio-nal hydroxyapatite composites for orthopedic applications: a review[J]. ACS Biomater Sci Eng, 2022, 8(8): 3162-3186.
[3] Liu SY, Chen W, Xiao L, et al. Robust osteoconductive β‑tricalcium phosphate/L-poly(lactic acid) me-mbrane via orientation-strengthening technology[J]. ACS Biomater Sci Eng, 2023, 9(9): 5293-5303.
[4] 刘建伟, 赵强, 万昌秀. 医用聚乳酸体内降解机理及应用研究进展[J]. 航天医学与医学工程, 2001, 14(4): 308-312.
Liu JW, Zhao Q, Wan CX. Research progresses on degradation mechanism in vivo and medical applications of polylactic acid[J]. Space Med Med Eng, 2001, 14(4): 308-312.
[5] 崔秀敏, 王彭延. 医用合成可降解生物材料的新进展[J]. 国外医学生物医学工程分册, 1995, 18(6): 324-329.
Cui XM, Wang PY. The new development of medical application of biodegradable materials[J]. Fo-reign Med Sci (Biomater Eng Fasc), 1995, 18(6): 324-329.
[6] On SW, Cho SW, Byun SH, et al. Bioabsorbable osteofixation materials for maxillofacial bone surgery: a review on polymers and magnesium-based mate-rials[J]. Biomedicines, 2020, 8(9): 300.
[7] Liu AB, Qin Y, Dai JB, et al. Fabrication and performance of zinc-based biodegradable metals: from conventional processes to laser powder bed fusion[J]. Bioact Mater, 2024, 41: 312-335.
[8] Liang YJ, Dai JB, Zhang ZB, et al. Osteogenic and antibacterial enhancement by alloying design and microstructural modification of additively manufactured biodegradable metals[J]. Biomaterials, 2026, 324: 123481.
[9] 杨荣涛, 吕坤, 周海华, 等. 应用可吸收钉板固定颌面部骨折的注意事项[J]. 中国实用口腔科杂志, 2019, 12(6): 321-324.
Yang RT, Lü K, Zhou HH, et al. Considerations for application of resorbable screws and plates in maxillofacial fractures[J]. Chin J Pract Stomatol, 2019, 12(6): 321-324.
[10] Sukegawa S, Yamamoto N, Nakano K, et al. Biomechanical loading comparison between titanium and bioactive resorbable screw systems for fixation of intracapsular condylar head fractures[J]. Materials (Basel), 2020, 13(14): 3153.
[11] Zieliński R, Kozakiewicz M, Świniarski J. Comparison of titanium and bioresorbable plates in “a” shape plate properties-finite element analysis[J]. Materials (Basel), 2019, 12(7): 1110.
[12] Keskin YB. Biomechanical comparison of titanium and poly-L-lactic acid trapezoidal plates applied in a subcondylar fracture model[J]. J Craniofac Surg, 2023, 34(6): 1737-1740.
[13] Çimen E, Önder ME, Cambazoğlu M, et al. Compa-rison of different fixation types used in unilateral mandibular condylar fractures: an in vivo study with new biomechanical model[J]. J Craniofac Surg, 2016, 27(5): 1277-1281.
[14] Jung BT, Kim WH, Park B, et al. Biomechanical evaluation of unilateral subcondylar fracture of the mandible on the varying materials: a finite element analysis[J]. PLoS One, 2020, 15(10): e0240352.
[15] Sukegawa S, Kanno T, Yamamoto N, et al. Biomechanical loading comparison between titanium and unsintered hydroxyapatite/poly-L-lactide plate system for fixation of mandibular subcondylar fractures[J]. Materials (Basel), 2019, 12(9): 1557.
[16] Kozakiewicz M. Are magnesium screws proper for mandibular condyle head osteosynthesis[J]. Mate-rials (Basel), 2020, 13(11): 2641.
[17] Ahemad AZ, Rattan V, Jolly SS, et al. Biomechanical comparison of magnesium bioresorbable and titanium lag screws for mandibular symphysis fracture fixation: a finite element analysis[J]. J Stomatol Oral Maxillofac Surg, 2025: 102383.
[18] Kozakiewicz M. Change in pull-out force during resorption of magnesium compression screws for osteosynthesis of mandibular condylar fractures[J]. Materials (Basel), 2021, 14(2): 237.
[19] Schönegg D, Koch A, Müller GT, et al. Two-screw osteosynthesis of the mandibular condylar head with different screw materials: a finite element ana-lysis[J]. Comput Methods Biomech Biomed Engin, 2024, 27(7): 878-882.
[20] Wang CC, Hung JY, Uan JY, et al. Facile bioactive transformation of magnesium alloy surfaces for surgical implant applications[J]. Front Bioeng Biotechnol, 2023, 11: 1156525.
[21] 甄珍, 高进涛, 闵玥, 等. 可降解镁金属骨科植入器械简介及注册审评考量[J]. 生物骨科材料与临床研究, 2023, 20(4): 89-92, 96.
Zhen Z, Gao JT, Min Y, et al. Introduction and registration evaluation concerns of degradable magnesium-based orthopedic implants[J]. Orthop Biomech Mater Clin Study, 2023, 20(4): 89-92, 96.
[22] Razavi M, Huang Y. Assessment of magnesium-based biomaterials: from bench to clinic[J]. Biomater Sci, 2019, 7(6): 2241-2263.
[23] Suuronen R, Haers PE, Lindqvist C, et al. Update on bioresorbable plates in maxillofacial surgery[J]. Facial Plast Surg, 1999, 15(1): 61-72.
[24] Ayasaka K, Ramanathan M, Huy NX, et al. Evaluation of hard and soft tissue responses to four diffe-rent generation bioresorbable materials-poly-L-lactic acid (PLLA), poly-L-lactic acid/polyglycolic acid (PLLA/PGA), uncalcined/unsintered hydroxyapatite/poly-L-lactic acid (u-HA/PLLA) and uncalcined/unsintered hydroxyapatite/poly-L-lactic acid/polyglycolic acid (u-HA/PLLA/PGA) in maxillofacial surgery: an in-vivo animal study[J]. Materials (Basel), 2023, 16(23): 7379.
[25] Sharma R, Mehrotra N, Singh I, et al. Development and characterization of PLA nanocomposites reinforced with bio-ceramic particles for orthognathic implants: enhanced mechanical and biological pro-perties[J]. Int J Biol Macromol, 2024, 282(Pt 3): 136751.
[26] Kim SM, Jo JH, Lee SM, et al. Hydroxyapatite-coa-ted magnesium implants with improved in vitro and in vivo biocorrosion, biocompatibility, and bone response[J]. J Biomed Mater Res A, 2014, 102(2): 429-441.
[27] Kim SM, Kang MH, Kim HE, et al. Innovative micro-textured hydroxyapatite and poly(l-lactic)-acid polymer composite film as a flexible, corrosion resistant, biocompatible, and bioactive coating for Mg implants[J]. Mater Sci Eng C Mater Biol Appl, 2017, 81: 97-103.
[28] Lim HK, Byun SH, Woo JM, et al. Biocompatibility and biocorrosion of hydroxyapatite-coated magnesium plate: animal experiment[J]. Materials (Basel), 2017, 10(10): 1149.
[29] 常欣楠, 刘磊. 生物可降解镁基材料在颅颌面外科的应用及其研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 107-115.
Chang XN, Liu L. Applications and research pro-gress of biodegradable magnesium-based materials in craniomaxillofacial surgery[J]. Int J Stomatol, 2024, 51(1): 107-115.
[30] Abdel-Galil K, Loukota R. Fixation of comminuted diacapitular fractures of the mandibular condyle with ultrasound-activated resorbable pins[J]. Br J Oral Maxillofac Surg, 2008, 46(6): 482-484.
[31] McLeod NMH, Saeed NR. Treatment of fractures of the mandibular condylar head with ultrasound-activated resorbable pins: early clinical experience[J]. Br J Oral Maxillofac Surg, 2016, 54(8): 872-877.
[32] McLeod NH, Gijn DV. Use of ultrasound-activated resorbable sheets and pins in the management of fractures of the condylar neck of the mandible: a case series[J]. Br J Oral Maxillofac Surg, 2018, 56(3): 182-185.
[33] McLeod NM, Saeed NR, Gerber B. Remodelling of mandibular condylar head after fixation of fractures with ultrasound activated resorbable pins: a retrospective case series[J]. J Cranio Maxillofac Surg, 2023, 51(7/8): 460-466.
[34] Yan GQ, Chuo WY, Zhang R, et al. Evaluation of the effect of bioresorbable plates and screws in the treatment of condylar fractures, assisted by digital preoperative planning[J]. J Oral Maxillofac Surg, 2019, 77(7): 1434.e1-1434.e16.
[35] Chuo WY, Yan GQ, Zhang R, et al. Accurate treatment of condylar fracture assisted by three-dimensional prototype and bioresorbable plates[J]. J Oral Maxillofac Surg, 2021, 79(10): 2124.e1-2124.e9.
[36] Sonnow L, Könneker S, Vogt PM, et al. Biodegra-dable magnesium Herbert screw-image quality and artifacts with radiography, CT and MRI[J]. BMC Med Imaging, 2017, 17(1): 16.
[37] Zhao DW, Huang SB, Lu FQ, et al. Vascularized bone grafting fixed by biodegradable magnesium screw for treating osteonecrosis of the femoral head[J]. Biomaterials, 2016, 81: 84-92.
[38] Yu XB, Zhao DW, Huang SB, et al. Biodegradable magnesium screws and vascularized iliac grafting for displaced femoral neck fracture in young adults[J]. BMC Musculoskelet Disord, 2015, 16: 329.
[39] Chen LL, Lin ZF, Wang M, et al. Treatment of trauma-induced femoral head necrosis with biodegradable pure Mg screw-fixed pedicle iliac bone flap[J]. J Orthop Translat, 2019, 17: 133-137.
[40] Herber V, Labmayr V, Sommer NG, et al. Can hardware removal be avoided using bioresorbable Mg-Zn-Ca screws after medial malleolar fracture fixation? Mid-term results of a first-In-human study[J]. Injury, 2022, 53(3): 1283-1288.
[41] Heye P, Matissek C, Seidl C, et al. Making hardware removal unnecessary by using resorbable implants for osteosynthesis in children[J]. Children (Basel), 2022, 9(4): 471.
[42] Holweg P, Labmayr V, Schwarze U, et al. Osteotomy after medial malleolus fracture fixed with magnesium screws ZX00-a case report[J]. Trauma Case Rep, 2022, 42: 100706.
[43] Vujović S, Desnica J, Stanišić D, et al. Applications of biodegradable magnesium-based materials in reconstructive oral and maxillofacial surgery: a review[J]. Molecules, 2022, 27(17): 5529.
[44] Yerit KC, Hainich S, Enislidis G, et al. Biodegradable fixation of mandibular fractures in children: stability and early results[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100(1): 17-24.
[45] Landes CA, Ballon A. Indications and limitations in resorbable P(L70/30DL)LA osteosyntheses of displaced mandibular fractures in 4.5-year follow-up[J]. Plast Reconstr Surg, 2006, 117(2): 577-589.
[46] Stanton DC, Liu F, Yu JW, et al. Use of bioresorbable plating systems in paediatric mandible fractures[J]. J Cranio Maxillofac Surg, 2014, 42(7): 1305-1309.
[47] Li MX, Xing X, Li ZB, et al. Classification and treatment strategies for condylar fractures in children[J]. Br J Oral Maxillofac Surg, 2021, 59(7): 776-782.
[48] Zhang B, Liu ZH, Li J, et al. Open reduction and internal fixation of severely dislocated fractures of condylar neck and base using bioabsorbable miniplate in children: a 3-10 years follow-up study[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(11): 1987-1992.
[49] Xu JY, Zhou HH, Lv K, et al. Serious condylar head absorption in children with intracapsular condylar fractures treated operatively with long screws[J]. J Craniofac Surg, 2023, 34(2): 658-662.
[50] Kolk A, Neff A. Long-term results of ORIF of condylar head fractures of the mandible: a prospective 5-year follow-up study of small-fragment positional-screw osteosynthesis (SFPSO)[J]. J Craniomaxillofac Surg, 2015, 43(4): 452-461.
[51] Smolka W, Cornelius CP, Lechler C. Resorption behaviour of the articular surface dome and functional outcome after open reduction and internal fixation of mandibular condylar head fractures using small-fragment positional screws[J]. J Craniomaxillofac Surg, 2018, 46(11): 1953-1959.
[52] Neuhaus MT, Gellrich NC, Sander AK, et al. No significant bone resorption after open treatment of mandibular condylar head fractures in the medium-term[J]. J Clin Med, 2022, 11(10): 2868.
[53] Kim DY, Sung IY, Cho YC, et al. Bioabsorbable plates versus metal miniplate systems for use in endoscope-assisted open reduction and internal fixation of mandibular subcondylar fractures[J]. J Cra-niomaxillofac Surg, 2018, 46(3): 413-417.
[54] 刘子健, 杨鸣良, 啜文钰. 可吸收内固定系统在双侧髁突骨折手术中应用的临床效果研究[J]. 中国实用口腔科杂志, 2021, 14(4): 466-469.
Liu ZJ, Yang ML, Chuo WY. The clinical effect study of absorbable internal fixation system in the operation of bilateral condyle fractures[J]. Chin J Pract Stomatol, 2021, 14(4): 466-469.
[55] Hao X, Lv K. An alternative location for fixation of subcondylar fractures with 2 resorbable plates[J]. J Craniofac Surg, 2023, 34(2): 757-758.
[56] Yerit KC, Hainich S, Turhani D, et al. Stability of biodegradable implants in treatment of mandibular fractures[J]. Plast Reconstr Surg, 2005, 115(7): 1863-1870.
[57] Song IS, Choi J, Kim SR, et al. Stability of bioabsorbable fixation systems according to different locations of mandibular fracture: a three-dimensional analysis[J]. J Craniomaxillofac Surg, 2021, 49(8): 732-737.
[58] Wu BX, Lin YX, Lv K. Management of mandibular condylar sagittal fracture accompanied by lateral condylar crest defect[J]. J Craniofac Surg, 2024, 35(5): e428-e429.
[59] Leonhardt H, Franke A, McLeod NH, et al. Fixation of fractures of the condylar head of the mandible with a new magnesium-alloy biodegradable cannulated headless bone screw[J]. Br J Oral Maxillofac Surg, 2017, 55(6): 623-625.
[60] Leonhardt H, Ziegler A, Lauer G, et al. Osteosynthesis of the mandibular condyle with magnesium-based biodegradable headless compression screws show good clinical results during a 1-year follow-up pe-riod[J]. J Oral Maxillofac Surg, 2021, 79(3): 637-643.
[61] Kozakiewicz M, Gabryelczak I. Bone union quality after fracture fixation of mandibular head with compression magnesium screws[J]. Materials (Basel), 2022, 15(6): 2230.
[62] Kozakiewicz M, Gabryelczak I, Bielecki-Kowalski B. Clinical evaluation of magnesium alloy osteosynthesis in the mandibular head[J]. Materials (Basel), 2022, 15(3): 711.
[63] Cho SM, Yang BE, Kim WH, et al. Biomechanical stability of magnesium plate and screw fixation systems in LeFort Ⅰ osteotomy: a three-dimensional finite element analysis[J]. Maxillofac Plast Reconstr Surg, 2024, 46(1): 40.
[64] Turostowski M, Rendenbach C, Herzog P, et al. Titanium vs PEO surface-modified magnesium plate fi-xation in a mandible bone healing model in sheep[J]. ACS Biomater Sci Eng, 2024, 10(8): 4901-4915.
[65] Sarian MN, Iqbal N, Sotoudehbagha P, et al. Potential bioactive coating system for high-performance absorbable magnesium bone implants[J]. Bioact Mater, 2022, 12: 42-63.
[66] Cheng M, Liang XG, Cui LH, et al. Magnesium-based nanocomposites for orthopedic applications: a review[J]. J Magnes Alloys, 2024, 12(11): 4335-4362.
[67] Hedayati R, Alavi M, Sadighi M. Effect of degradation of polylactic acid (PLA) on dynamic mechanical response of 3D printed lattice structures[J]. Materials (Basel), 2024, 17(15): 3674.
[1] 胡雅瑄,马子涵,王将凌,汪永跃. 可降解新型聚乳酸膜在引导骨组织再生中的应用[J]. 国际口腔医学杂志, 2024, 51(2): 187-192.
[2] 常欣楠,刘磊. 生物可降解镁基材料在颅颌面外科的应用及其研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 107-115.
[3] 陈克难,郭传瑸. 可降解医用镁基金属生物材料的研究进展[J]. 国际口腔医学杂志, 2021, 48(3): 322-328.
[4] 王春燕, 张琨, 姜松磊. 聚乳酸根管桩修复乳牙残根残冠的研究进展[J]. 国际口腔医学杂志, 2018, 45(1): 74-77.
[5] 朱晸,史俊. 儿童下颌骨髁突骨折的治疗进展[J]. 国际口腔医学杂志, 2017, 44(2): 222-227.
[6] 李晓宇 刘政华 蔡剑波. 17 例儿童髁突骨折保守治疗的临床分析[J]. 国际口腔医学杂志, 2012, 39(6): 733-735.
[7] 陈之彪综述 辛鹏飞 徐兵审校. 颌面部爆炸伤的研究进展[J]. 国际口腔医学杂志, 2012, 39(2): 214-216.
[8] 卢群1 杨显方2. 38例纵折磨牙保存治疗的临床疗效观察[J]. 国际口腔医学杂志, 2011, 38(2): 131-133.
[9] 李波,龙星. 内窥镜在髁突骨折治疗中的应用[J]. 国际口腔医学杂志, 2005, 32(02): 140-141.
[10] 邓润智,胡勤刚. 生物降解接骨材料在颅颌面外科的临床应用研究[J]. 国际口腔医学杂志, 2005, 32(01): 79-81.
[11] 宁秋,余兰. 可吸收聚合物及其复合物在口腔颌面外科领域的应用进展[J]. 国际口腔医学杂志, 2004, 31(S1): -.
[12] 乔永明. 真性颞下颌关节强直和创伤关系的研究[J]. 国际口腔医学杂志, 2004, 31(S1): -.
[13] 王晓静,何黎升,曹强. 非加压小型接骨板在下颌角骨折坚强内固定中的应用方式比较[J]. 国际口腔医学杂志, 2004, 31(06): 472-474.
[14] 彭勇 李伯友 魏世成. 可吸收夹板颌面部骨折内固定的研究与应用[J]. 国际口腔医学杂志, 2003, 30(06): 478-480.
[15] 罗恩 魏世成. 聚乳酸与聚乳酸羟基乙酸共聚物作为骨形成蛋白载体的研究现状[J]. 国际口腔医学杂志, 2003, 30(04): 260-262.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!