The use of biodegradable fixation in sagittal split and vertical subsigmoid osteotomy of the mandible: a preliminary report

Objective: An absorbable pin made from poly-p-dioxanone (Orthosorb, Johnson and Johnson, UK) was used to internally fix osteotomies of the mandibular ramus. We present our initial series of 10 patients. Design: Open study. Setting: Regional unit, teaching hospital, UK. Subjects and interventions: 10 patients who required a bilateral sagittal split osteotomy (BSS, n = 3) or a vertical subsigmoid osteotomy (BVSS, n = 6), or both (n = 1). Main outcome measure: Jaw functioning and ability to open mouth. Results: 9/10 followed up for 1 year, 1/10 lost to follow up at one month, 1/10 lost to follow up at one year. 7/9 reported the same degree of mouth opening as preoperatively, 2/9 slightly less. 3/10 developed slight anterior open bite problems; 1/10 required no treatment, 1/10 improved with selective grinding, and 1/10 was lost to follow up. No patient complained of discharge from the site of the implant or of any change in sensation of the lip. Conclusion: Small absorbable implants undoubtedly have a place in selected maxillofacial operations, but there are still some problems with their use, including complications during the learning curve.