Are resorbable plating systems comparable to conventional titanium plating in paediatric maxillofacial trauma patients? A systematic review and meta-analysis.

This systematic review and meta-analysis evaluated the effectiveness of resorbable versus titanium plating systems in the management of paediatric maxillofacial fractures. A comprehensive search of PubMed, Embase, Scopus, and specialty journals up to December 2024 identified six retrospective studies published between 2010 and 2024, involving 1,584 patients aged ≤18 years. Both resorbable and titanium systems provided satisfactory fracture stability and healing. Titanium fixation was consistently associated with higher complication rates, ranging from 8%-12% whereas resorbable systems demonstrated rates of 0%-11%, mostly minor complications. Titanium fixation was frequently associated with hardware removal, with reported rates ranging from 15%-95%, reflecting both complication-related and protocol-driven removals, whereas none of the resorbable systems required secondary surgery for hardware removal. Meta-analysis demonstrated a non-significant reduction in complication odds with resorbables compared with titanium (odds ratio 0.42; 95% confidence interval 0.12 to 1.48; p = 0.18; I2 = 52%). These findings indicate that resorbable plating systems offer comparable stability to titanium, with fewer complications and the significant advantage of eliminating the need for removal. Titanium remains the preferred option for load-bearing mandibular fractures due to its superior mechanical strength, while resorbables appear effective for non-load-bearing and growth-sensitive sites. Further prospective trials with long-term follow up are required to confirm their impact on craniofacial growth and cost-effectiveness.