Clinical Outcomes of Bioresorbable Versus Titanium Fixation in Anterior Maxillary Segmental Osteotomy: A Randomized Clinical Trial

This study aims to compare the clinical outcomes of bioresorbable and titanium fixation systems used in anterior maxillary segmental osteotomy (AMSO) procedures, with a focus on skeletal stability, postoperative complications, and hardware-related morbidity. A prospective, randomized clinical trial was conducted on 50 patients undergoing AMSO. Participants were randomly assigned to 2 groups: bioresorbable fixation using poly- L -lactic acid/polyglycolic acid (PLLA/PGA) (n=15) and conventional titanium miniplates (n=35). Standardized panoramic and cephalometric radiographs were taken preoperatively and at 1 and 12 months postoperatively. Primary outcome measures included skeletal stability assessed by horizontal and vertical movement of the anterior maxillary segment. Secondary outcomes included postoperative infection, wound dehiscence, plate palpability, radiographic verification of correct segmental positioning, and the need for hardware removal. At 1 and 12 months, cephalometric radiographs in both groups demonstrated comparable skeletal stability, with no statistically significant differences in relapse rates. The incidence of infection and wound dehiscence was similar across groups. However, the titanium group had a significantly higher rate of hardware removal requests (8.6% vs. 0%, P < 0.05). No major adverse events were reported in either group. Bioresorbable fixation systems provide comparable skeletal stability to titanium plates in AMSO, while eliminating the need for secondary hardware removal. These findings support the selective use of bioresorbable fixation, particularly in patients for whom hardware removal is undesirable.