MAKSİLLOFASİYAL TRAVMA TEDAVİSİ İÇİN ISI İLE ŞEKİLLENDİRİLEBİLEN KOMPOZİT KEMİK PLAKALARININ GELİŞTİRİLMESİ

Abstract

Facial bone fractures (nose fractures, lower jaw fractures, upper jaw fractures, cheekbone fractures) resulting from facial injuries resulting from severe trauma can be treated using plate and screw systems. Depending on the location of the fracture, the fracture lines are brought end to end by entering from the inner part of the lower lip, the inner part of the upper lip, under the eye, near the eye, over the eyebrow, and under the chin, and the fractures are fixed with plates and screws. Many clinicians prefer metal implants due to their high mechanical strength. However, there are structural problems such as pain and local irritation associated with the use of metallic implants. You may also need a second surgery to remove the metallic fixation. In this thesis study, biodegradable plates were designed to be used in the treatment of maxillofacial bone injuries. Biodegradable fracture fixation plates were preferred because they degrade slowly in the human body, cause less pain and stress, and do not require a second process to remove the synthetic material. Different proportions of trimethylene carbonate (TMC), poly-L-lactate (LPLA), poly(D, L-lactate) (DLPLA), polyglycolate (PGA) and beta-tricalcium phosphate (β-TCP) are mixed by extrusion and injection molded into plates. has been obtained. Comprehensive morphological, thermal, mechanical and in vitro degradation behaviors of the obtained plates were examined. In addition, the effects of extrusion and molding parameters on the physical and chemical structure of bone plates were also examined within the scope of the study. Ceramic-based biodegradable β-TCP facial treatment plates have been composited with other products to add buffering properties, and thus plates have been developed that can prevent the necrosis problem caused by the decrease in environmental pH as a result of the degradation encountered in polymeric materials. In addition, by using TMC (Tri-methylene carbonate) in the structure of the plates, composite products compatible with the human body that can be deformed in a water bath have been obtained. In the water deformation tests, it was observed that all the plates returned to their initial shape after being deformed in a helical shape when left in the water at 65 ○C. All bone plates obtained showed non-cytotoxic properties in cell culture studies. In the degradation experiments carried out under artificial conditions, the degradation behavior of the plates in 20 mL lactated Ringer's solutions in a continuous shaking system for 90 days was examined. It has been observed that as the percentage of PGA additive in the plates increases, the degradation rate also increases. In the study, maxillofacial region bone treatment plates were developed that minimize the risk of endogenous infection, do not destroy bone tissue, do not require a second surgery to remove the bone after healing, are biodegradable, environmentally friendly, and can be adjusted to the required flexibility and hardness with its polymer-ceramic structure.