Title Long-Term Skeletal Stability Following BSSO Advancement is Similar for Titanium and Biodegradable Fixation Systems
Clinical Question Is there a difference in the long-term skeletal stability of a BSSO advancement stabilized with titanium or biodegradable fixation?
Clinical Bottom Line There was no significant difference in skeletal stability over a 2 year period for patients who had BSSO advancements using titanium or biodegradable fixation.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
25138611Van Bakelen/2014230 patients who required treatment of trauma or orthognathic conditions. After the exclusions, n=15 for BSSO advancement with Biodegrable fixation and n= 22 for BSSO advancement with titanium fixationCohort Study
Key resultsIn a 2 year follow up study, BSSO advancements stabilized with biodegradable plates and screws (Inion CPS) and titanium plates and screws (KLS Martin) showed no significant differences in horizontal and vertical stability at points B and Pg.
Evidence Search "bsso"[All Fields] AND advancement[All Fields] AND skeletal[All Fields] AND stability[All Fields]
Comments on
The Evidence
Validity: In this cohort study, 149 out of 230 patients completed the 2 year postoperative follow-up. After the exclusions, only 15 patients in the biodegradable group and 22 in the titanium group were analyzed. In the original study, there was only 65% followup that could introduce a degree of bias. Hence, this bias limit the validity of the result. Perspective: The original study was a randomized controlled trial but after further analysis, the study only looked at a selected subpopulation. More clinical trials are needed to further evaluate any statistical differences in long-term skeletal stability for patients who undergo BSSO advancement with titanium vs. biodegradable fixation systems.
Applicability Biodegradable fixation is a new rising technology and a viable option in the near future. The advantages of this new system are short-term stability, the intra-operative switches, the number of plates that required removal, and cost-effectiveness. Due to limited amount of information given, the study does not provide enough information to guide a definitive decision at this time.
Specialty (Oral Surgery)
Keywords BSSO advancements, KLS plates, titanium fixation system, biodegradable fixation system, Inion CPS plates
ID# 2888
Date of submission 04/14/2015
E-mail lamn@livemail.uthscsa.edu
Author Nguyen Lam
Co-author(s) e-mail
Faculty mentor Edward Ellis, III, DDS
Faculty mentor e-mail ellise3@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available