A novel alloplastic grid reconstruction plate for the mandible - Retrospective comparative clinical analysis of failure rates and specific complications

Matthias W Gielisch; Fabia Siegberg; Daniel G E Thiem; Sebastian Blatt; Diana Heimes; Peer W Kämmerer

doi:10.1016/j.jcms.2023.07.005

A novel alloplastic grid reconstruction plate for the mandible - Retrospective comparative clinical analysis of failure rates and specific complications

J Craniomaxillofac Surg. 2023 Jul-Aug;51(7-8):448-453. doi: 10.1016/j.jcms.2023.07.005. Epub 2023 Aug 1.

Authors

Matthias W Gielisch¹, Fabia Siegberg¹, Daniel G E Thiem¹, Sebastian Blatt¹, Diana Heimes¹, Peer W Kämmerer²

Affiliations

¹ Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
² Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany. Electronic address: peer.kaemmerer@unimedizin-mainz.de.

PMID: 37550114
DOI: 10.1016/j.jcms.2023.07.005

Abstract

Purpose: This study aimed to investigate the effect of three different osteosynthesis plate systems on failure rates and complications after continuity-interrupting mandibular resections with alloplastic reconstructions.

Materials and methods: Records of respective patients from 2010 to 2020 were analyzed retrospectively. The analyses included the osteosynthesis plate type (2.4 MANDIBULAR (RP1: MANDIBULAR [Medicon®, Tuttlingen, Germany]; RP2: Modus® Reco 2.5 [Medartis®, Basel, Switzerland]; and RP3: Modus 2 Mandible [Medartis®, Basel, Switzerland]), extent & location of the defect, age, sex, radiotherapy, and nicotine abuse. In case of failure, timepoint, and the problem, namely oral/extraoral dehiscence, screw loosening, and plate fractures that led to removal, were analyzed. Complications were classified according to Clavien-Dindo system.

Results: A total of 136 patients were included. The mean follow-up time was 18 ± 26 months. Survival rates after 1, 2, and 5 years were 69.9%, 66.9%, and 64.7%, respectively. Although survival was not significantly associated with the reconstruction system, the most frequent complications were seen in cases of RP1 & RP2 when compared to RP3 (p = 0.033). In brief, dehiscences were seen significantly less often in cases of RP3 (12.5%) when compared to RP1 (44.7%) and RP2 (26.9%; p = 0.024). Fractures of the osteosynthesis systems occurred in 3 of 4 cases (75%) with RP1, in 1 of 4 cases (25%) using RP2, and in no single case using the RP3 system (p = 0.03). Most of the observed complications occurred up to 12 months postoperatively. A total plate survival rate of 64.7% and a total plate complication rate of 47.8% were seen.

Conclusion: In conclusion, it seems that RP3 should be preferred over RP1 and RP2 regarding failure rates and complications.

Keywords: Alloplastic reconstruction; Clinical comparative analysis; Grid plate; Mandibular reconstruction; Oral oncology; Osteosynthesis system.

MeSH terms

Bone Plates / adverse effects
Germany
Humans
Mandible / surgery
Mandibular Neoplasms* / surgery
Mandibular Reconstruction*
Retrospective Studies