Biodegradable Devices Across Orthopedic and Maxillofacial Surgery: A Review of Biomaterials, Advances, and Challenges.

Abstract

The use of biodegradable alternatives to conventional metallic orthopedic devices addresses several inherent limitations of permanent implants by providing temporary mechanical support, obviating the need for secondary removal surgeries, and potentially lowering overall healthcare costs. This review summarizes the principal classes of biodegradable materials-metals (e.g., magnesium, zinc), polymers (e.g., PLGA, PLLA), and bioceramics-and their applications across diverse device types, including screws, nails/rods, plates, and scaffolds. Drawing upon evidence from clinical and preclinical studies, we evaluate the material-specific advantages within each device category and critically examine their associated challenges, such as rapid degradation leading to fixation loss, gas evolution resulting in tissue disruption, and mechanical mismatch contributing to stress shielding. Cost-effectiveness is emphasized through the potential reduction in reoperation rates. Moreover, we highlight integrative technological advances (including surface modification, additive manufacturing, and drug-eluting designs) that are shaping the next generation of biodegradable implants. As clinical evidence continues to accumulate, the future success of these devices will depend on achieving an optimal balance between degradation kinetics and bone healing, conducting large-scale multicenter trials, and leveraging modern bioengineering and computational tools.