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Madhu SK, Dominic S, Baptist J, Shetty P. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024; 25:289-291. [PMID: 38690704 DOI: 10.5005/jp-journals-10024-3650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
AIM This clinical technique aims to retighten intermaxillary fixation (IMF) wires when loosened intra/postoperatively. BACKGROUND Intermaxillary fixation is one of the most important steps to obtain stable and functional occlusion in maxillofacial trauma. However, IMF wires tend to loosen over time. This loosened wire is generally removed and a new wire is used for IMF. Removal and refixation is time-consuming for surgeon and unconformable for the patient. TECHNIQUE We recommend a simple technique for re-tightening IMF wires without breakage, with the use of shepherd's crook explorer by making a small circular loop. CONCLUSION This technique of re-tightening by looping further stretches and tightens the wire to regain stabilized occlusion with maximal intercuspation. CLINICAL SIGNIFICANCE This technique eliminates the need for removal and refixation of IMF wires, thereby improving patient comfort, yet obtaining stable occlusion over a long period of time. How to cite this article: Madhu SK, Dominic S, Baptist J, et al. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024;25(3):289-291.
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Affiliation(s)
- Sandeep K Madhu
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India, Orcid: https://orcid.org/0000-0002-6167-0388
| | - Shiney Dominic
- Department of Oral and Maxillofacial Surgery, Government Dental College, Thrissur, Kerala, India, Orcid: https://orcid.org/0000-0002-1977-9646
| | - Joanna Baptist
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India, Phone: +91 9480528512, e-mail: , Orcid: https://orcid.org/0000-0003-1075-8950
| | - Premalatha Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India, Orcid: https://orcid.org/0000-0002-3474-1726
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Kapoor S, Gupta A, Bansal P, Sharma SD, Gupta H, Srivastava R. Clinical Outcomes of ULTRA EZY Bar vs Erich Arch Bar in Conservative Management of Maxillofacial Fractures: A Randomized Controlled Trial. J Maxillofac Oral Surg 2024; 23:122-128. [PMID: 38312966 PMCID: PMC10831013 DOI: 10.1007/s12663-022-01821-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 11/06/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Various techniques have been employed from time to time to achieve maxillomandibular fixation, and arch bars provide an effective and versatile means of maxillomandibular fixation, and however, some of the issues occurring with it have been eliminated with the introduction of Ultralock EZY bar. The aim of the present study is to compare the advantages and disadvantages of Ultralock Ezy bar over the Erich arch bar in mid-face fracture or maxillary fracture or mandibular fracture or both requiring conservative treatment. Materials and Methods A total of 20 patients reported to the Department of Oral and Maxillofacial Surgery in Sudha Rustagi Dental College and Hospital, Faridabad, with mid-face fracture/maxillary fracture, mandibular fracture or both. The treatment plan required intermaxillary fixation. As a part of treatment plan, group was selected randomly divided into 20 arches in each group that is test arch group and control arch group.Test arch group included arches in which Ultralock EZY bar was done. Control arch group included arches in which Erich arch bar was done. The parameters compared in both the groups were surgical time taken, injuries due to wires, arch bar stability, oral hygiene index, patient acceptance and comfort, pulp vitality, and complication (if any). Results The average surgical time taken was less, and oral hygiene status and patient acceptance were better in test group. There was not much statistically significant difference in pulp vitality but number of cases with absence of pulp vitality were more in test group. Conclusion This study emphasizes the use of Ultralock Ezy bar as a quick and easy method than Erich arch bar. Oral hygiene maintenance was comparatively better in patients with Ultralock Ezy bar than those with Erich arch bar. For the patients who require long-term IMF, Ultralock Ezy bars can be a viable option. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-022-01821-3.
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Affiliation(s)
- Shivangini Kapoor
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Ashish Gupta
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Pankaj Bansal
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Sneha D. Sharma
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana India
| | - Himani Gupta
- Department of Oral and Maxillofacial Surgery Sudha Rustagi College of Dental Sciences, Faridabad, Haryana India
| | - Rachit Srivastava
- Department of Oral and Maxillofacial Surgery Sudha Rustagi College of Dental Sciences, Faridabad, Haryana India
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Elhadidi MH, Awad S, Elsheikh HAE, Tawfik MAM. Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial. J Contemp Dent Pract 2023; 24:928-935. [PMID: 38317388 DOI: 10.5005/jp-journals-10024-3613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM This study aimed to compare the clinical outcomes of a conventional Erich's arch bar vs a modified screw-retained arch bar in maxillomandibular fixation of mandibular fracture. MATERIALS AND METHODS This parallel-arm randomized control trial included patients from the outpatient clinic with single favorable mandibular fractures that are indicated for closed reduction. They were subjected to maxillomandibular fixation using conventional Erich's arch bars in the control group and modified screw-retained arch bars in the study group. The outcome measures included operating time, glove perforations, postoperative pain, oral hygiene, fixation stability, occlusion, and mucosal coverage. RESULTS A total of 20 patients (12 males and 8 females) with a 1:1 allocation ratio were included. There was a significant statistical difference regarding operation time and number of glove perforations in favor of group B as p < 0.001, p = 0.007, respectively. There was a significant statistical difference regarding pain after 1 day (p < 0.001), 1 week (p < 0.001) in favor of group B, and at 4 weeks (p = 0.015), and 6 weeks (p = 0.002) in favor of group A. Regarding oral hygiene at 1 week (p = 0.021) and at 6 weeks (p < 0.001), there was a significant statistical difference in favor of group B. Regarding mucosal coverage at 6 weeks, there was a significant statistical difference in favor of group A (p = 0.005). CONCLUSION The modified screw-retained arch bar can be considered an alternative to conventional arch bar as it provided less application time and better operator safety. It also showed better patient satisfaction regarding pain and oral hygiene. CLINICAL SIGNIFICANCE Maxillomandibular fixation with the conventional technique was modified to screw-retained arch bar which is less time-consuming and provides better patient and operator satisfaction. How to cite this article: Elhadidi MH, Awad S, Elsheikh HAE, et al. Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial. J Contemp Dent Pract 2023;24(12):928-935.
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Affiliation(s)
- Merna Hosny Elhadidi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
| | - Sally Awad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
| | - Heba Abo-Elfetouh Elsheikh
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt, Phone: +20 1024461010, e-mail:
| | - Mohamed Abdel-Monem Tawfik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
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The Assessment of Intermaxillary Fixation and Open Reduction Using Skeletal Anchorage System Compared With Arch Bar in Mandible Fracture Based on CT Image. J Craniofac Surg 2023:00001665-990000000-00641. [PMID: 36935402 DOI: 10.1097/scs.0000000000009308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/28/2022] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND There are many different techniques to achieve intermaxillary fixation (IMF) for open reduction of mandible fractures. The arch bar has long been used as the gold standard of IMF to assist open reduction. However, owing to its long operating time, risk of needle stick injury, and gingival trauma, surgeons looked into different treatment options for IMF, such as the skeletal anchorage system (SAS). Therefore, this study aimed to compare the stability between IMF with arch bar and IMF with SAS based on computed tomography image. MATERIALS AND METHODS In this retrospective study, postoperative computed tomography and panoramic radiographs were taken 1 week and 6 months after surgery, respectively. The treatment of mandibular fractures using IMF with arch bar and SAS were compared by evaluating changes in the dental midlines and condyle positions. Thirty patients with mandibular fractures were enrolled into 2 groups-IMF with arch bar and IMF with SAS. RESULTS The arch bar showed slightly more deviation in dental midline. In SAS, the condyle moved more medially compared with the arch bar. CONCLUSIONS Skeletal anchorage system could be used for IMF with reliable stability in mandible fracture. There were no significant differences in the treatment outcome between the 2 groups.
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Weill P, Garmi R, Thobie A, Benateau H, Veyssiere A. Focus on the use of maxillomandibular fixation in mandibular fracture oseosynthesis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e614-e618. [PMID: 35093587 DOI: 10.1016/j.jormas.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the efficiency of three methods of isolated mandibular fracture intraoperative reduction. MATERIALS AND METHODS This 6-year retrospective study included patients with isolated extra-articular mandibular fractures who would benefit from osteosynthesis. The endpoint was postoperative occlusion according to the type of intraoperative immobilization: screws, arch, or manual reduction. RESULTS A total of 145 patients were included, with 233 fractures. Forty-five patients underwent manual reduction without maxillo-mandibular fixation (MMF), 51 MMF with screws, and 49 MMF with arch, with 11.1%, 5.9% and 4.1% of patients in these groups experiencing postoperative malocclusion, respectively. The overall malocclusion rate was 6.9%. There was no significant difference among the 3 methods according to univariate statistical analysis (p = 0.42) or after comparing MMF (grouping screws and arches) to manual reduction without MMF (p = 0.29). CONCLUSION This study did not show a significant difference between the different methods of intraoperative reduction of isolated extra-articular mandibular fractures, even though intraoperative MMF was much more commonly used for complex fractures. However, there is a non-significant tendency to get a better post-operative occlusal result with MMF, which remains the reference traitement. Intraoperative manual reduction without MMF may be used within trained teams in some instances.
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Affiliation(s)
- Pierre Weill
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Medecine Faculty of CAEN, University of Caen Basse-Normandie, Caen 14032 Cedex 5, France.
| | - Rachid Garmi
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France
| | - Alexandre Thobie
- Department of Visceral Surgery, Caen University Hospital, Caen 14000, France
| | - Hervé Benateau
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Department of Visceral Surgery, Caen University Hospital, Caen 14000, France
| | - Alexis Veyssiere
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Medecine Faculty of CAEN, University of Caen Basse-Normandie, Caen 14032 Cedex 5, France; Unicaen, Bioconnect, Normandie Université, CAEN 14000, France
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Effect of a digital guide on the positional accuracy of intermaxillary fixation screw implantation in orthognathic surgery. J Plast Reconstr Aesthet Surg 2022; 75:e15-e22. [PMID: 35367159 DOI: 10.1016/j.bjps.2022.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/27/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intermaxillary fixation screw (IMFS) implantation is a common procedure in orthognathic surgery (OGS) performed to the temporary maxillary-mandibular fixation and stable bite relationships. The study aims to assess the accuracy of IMFS implantation with a digital guide to reduce the occurrence of root damage. METHODS This prospective study involved 40 patients undergoing OGS at the Affiliated Hospital of Qingdao University from August 2017 to May 2021. The patients were randomly divided into two groups according to whether the IMFS implantation was with or without digital guide (20 patients in the experimental group and 20 controls). The digital guides used in the experimental group were designed according to a virtual implantation plan and printed using stereolithography. In the control group, IMFSs were directly implanted by a surgeon based on clinical experience. Postoperatively, cone-beam computed tomography was performed to compare root proximity of IMFSs between the two groups and verify the accuracy of IMFS placement. RESULTS In the experimental group, there was no case of root damage, the incidence of the periodontal ligament (PDL) injured was 22.1%, and 77.9% IMFSs were placed without contacting adjacent anatomic structures. In the control group, the incidence of root damage had been up to 20.8%, 31.7% IMFSs injured the PDL, and only 47.5% IMFSs were placed between the roots (P < 0.001). CONCLUSION IMFSs can be placed more accurately with surgical guides, reducing the incidence of root and PDL damages.
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Long term clinical result of implant induced injury on the adjacent tooth. Sci Rep 2021; 11:7913. [PMID: 33846470 PMCID: PMC8041840 DOI: 10.1038/s41598-021-87062-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/23/2021] [Indexed: 11/08/2022] Open
Abstract
The purpose of the retrospective study was to investigate the long-term result of implant-induced injury on the adjacent tooth. The subjects of this retrospective study were patients who had received implants and had tooth injury; direct invasion of root (group I), root surface contact (group II), or < 1 mm distance of the implant from the root (group III). Clinical and pathological changes were periodically examined using radiographs and intra-oral examinations. Paired t-tests and chi-square tests were used to evaluate the implant stability quotient (ISQ) of implant and tooth complications, respectively (α = 0.05). A total of 32 implants and teeth in 28 patients were observed for average 122.7 (± 31.7, minimum 86) months. Seven teeth, three of which were subsequently extracted, needed root canal treatment. Finally, 90.6% of the injured teeth remained functional. Complications were significant and varied according to the group, with group I showing higher events than the others. The ISQs increased significantly. One implant in group I resulted in osseointegration failure. The implant survival rate was 96.9%. In conclusion, it was found even when a tooth is injured by an implant, immediate extraction is unnecessary, and the osseointegration of the invading implant is also predictable.
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Fracture propagation associated with intermaxillary fixation screws in maxillofacial trauma. Int J Oral Maxillofac Surg 2019; 49:491-495. [PMID: 31570287 DOI: 10.1016/j.ijom.2019.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/17/2019] [Accepted: 09/12/2019] [Indexed: 11/22/2022]
Abstract
Intermaxillary fixation (IMF) screws are commonly used for maxillomandibular immobilization in the management of mandible fractures as definitive closed reduction treatment or in adjunct intraoperatively. In this report, we present three cases of isolated unilateral mandible fractures, in which IMF screws were used and resulted in propagation of a second fracture on the contralateral side, at the site where IMF screws were placed during the surgery. The use of IMF screws has many advantages with an overall low risk of morbidity, however, there are potential complications that must be recognized.
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Pathak P, Thomas S, Bhargava D, Beena S. A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich's arch bar (CEAB). Oral Maxillofac Surg 2019; 23:285-289. [PMID: 31127404 DOI: 10.1007/s10006-019-00766-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/30/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Intermaxillary fixation (IMF) is commonly performed in the management of facial skeleton fractures. Various conventional methods like Erich's arch bar and Ivy eyelet wiring are the most commonly employed methods for achieving IMF, but they have their own disadvantages. Conventional Erich's arch bar (CEAB) has been modified recently by making perforations in the spaces between the winglets and securing the arch bar using 1 mm screws. IMF using intraoral modified screw retained arch bar (SRAB) has been introduced for the treatment of mandibular fractures. The aim of this study was to compare the efficacy, advantages, disadvantages, indications, and potential complications associated with CEAB versus modified SRAB in the management of mandibular fractures. MATERIALS AND METHODS A randomized prospective study included 20 patients with mandibular fracture who were randomly allotted to two groups. Group A patients received modified SRAB and group B patients received CEAB. The parameters considered were time taken to place the arch bar, perforation in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle (wire) stick injuries during IMF. RESULTS The mean time taken for arch bar placement was 27.20 min with modified SRAB as compared with 82.50 min with CEAB. Incidence of glove perforations was more in group B patients. Oral hygiene status was good in 90% of the patients from group A whereas it was 100% fair in group B patients. CONCLUSION This study has shown that both the techniques achieve satisfactory IMF with post-operative occlusion. IMF with modified SRAB reduces the operating time and the incidence of the needle (wire) prick injuries. But modified SRAB has its own limitations in spite of its ease of application.
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Affiliation(s)
- Pankaj Pathak
- Oral and Maxillofacial Surgery, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhanpur, Bhopal, 462 037, Madhya Pradesh, India
| | - Shaji Thomas
- Oral and Maxillofacial Surgery, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhanpur, Bhopal, 462 037, Madhya Pradesh, India
| | - Darpan Bhargava
- Oral and Maxillofacial Surgeon, Private Practice, H-3/2, BDA Colony, Nayapura, Lalghati, Airport Road, Bhopal, 462 001, Madhya Pradesh, India.
| | - Sivakumar Beena
- Oral and Maxillofacial Surgery, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhanpur, Bhopal, 462 037, Madhya Pradesh, India
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Comparison Between Intermaxillary Fixation With Screws and an Arch Bar for Mandibular Fracture. J Craniofac Surg 2019; 30:1787-1789. [DOI: 10.1097/scs.0000000000005488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pedemonte C, Valenzuela K, González LE, Vargas I, Noguera A. Types of Intermaxillary Fixation and Their Interaction With Palatine Fracture Reduction. J Oral Maxillofac Surg 2019; 77:2083.e1-2083.e8. [PMID: 31310733 DOI: 10.1016/j.joms.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To compare 3 types of intermaxillary fixation (IMF) and their behavior when subjected to tension forces in 3 study models with a palatine fracture feature. MATERIALS AND METHODS An experimental study of 3 identical acrylic models was performed. All had the same palatine fracture pattern on the maxillary midline. All were reduced with different IMF methods (ie, direct interdental wiring, Erich arch bars, and self-tapping screws). Tension forces were applied to the study models to observe the fracture line behavior. RESULTS IMF with direct interdental wiring did not cause significant separation of the fracture feature in the anterior or posterior sector. IMF with the Erich arch bars caused a 2-mm separation in the anterior sector and 0 mm in the posterior sector. The IMF with self-tapping screws caused a 3-mm separation in the anterior sector and 1 mm in the posterior sector. CONCLUSIONS IMF using self-tapping screws resulted in the greatest separation of the fracture compared with the results with Erich arch bars and direct interdental wiring. IMF with self-tapping screws tended to displace the fracture lines by application of the vector furthest from the center of resistance.
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Affiliation(s)
- Christian Pedemonte
- Staff, Department of Oral and Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile.
| | - Katherine Valenzuela
- Resident, Department of Oral and Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
| | - L Edgardo González
- Head, Department of Oral and Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
| | - Ilich Vargas
- Staff, Department of Oral and Maxillofacial Surgery, Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago, Chile
| | - Alfredo Noguera
- Oral and Maxillofacial Surgeon, Universidad de Los Andes, Santiago, Chile
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Intraoperative Manipulation of Bony Segments: An Innovative Method. J Maxillofac Oral Surg 2018; 17:632-633. [DOI: 10.1007/s12663-018-1084-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022] Open
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Rastogi S, Ahmed T, Giri K, Dandriyal R, Indra B NP, Joshi A, Choudhury S, Mall S. Comparative Evaluation of the Embrasure Wire versus Arch Bar Maxillomandibular Fixation in the Management of Mandibular Fractures: Are Arch Bars Replaceable? Craniomaxillofac Trauma Reconstr 2018; 11:118-123. [PMID: 29892326 DOI: 10.1055/s-0037-1603453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022] Open
Abstract
The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t -test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B ( p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B ( p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.
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Affiliation(s)
- Sanjay Rastogi
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Tousif Ahmed
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Kolli Giri
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Ramakant Dandriyal
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Niranjana Prasad Indra B
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Ankur Joshi
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Shouvik Choudhury
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Kothiwal Dental College and Research Center, Moradabad, Uttar Pradesh, India
| | - Sunil Mall
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Rothe TM, Kumar P, Shah N, Shah R, Mahajan A, Kumar A. Comparative Evaluation of Efficacy of Conventional Arch Bar, Intermaxillary Fixation Screws, and Modified Arch Bar for Intermaxillary Fixation. J Maxillofac Oral Surg 2018; 18:412-418. [PMID: 31371884 DOI: 10.1007/s12663-018-1110-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 04/16/2018] [Indexed: 11/25/2022] Open
Abstract
Aim Comparative evaluation of efficacy of conventional arch bar, intermaxillary fixation screws, and modified arch bar with respect to plaque accumulation, time required for procedure, postoperative stability after achieving the intermaxillary fixation, mucosal growth, and complication encountered for intermaxillary fixation. Materials and methods This study is a randomized clinical trial in which participants were divided into three groups of 10 each, and designated as Group A, Group B, and Group C. In Group A, intermaxillary fixation was achieved by the conventional method using Erich arch bar, fastened with 26-gauge stainless-steel wires. In Group B, intermaxillary fixation was achieved by the use of 2 mm × 8 mm 4-6 stainless-steel intermaxillary fixation screws. In Group C, intermaxillary fixation was achieved by modified screw arch bar. A conventional arch bar was modified by making perforations in the spaces between the winglets along the entire extension of the bar which was then adapted to the vestibular surface of the maxilla and mandible, close to the cervical portion of the teeth, and perforations were made in the inter-radicular spaces with a 1.1-mm bur, and after this, 1.5-mm screws were placed to fix the bar. Results In the present study, a total of 30 patients were analyzed. The average working time for Group A, Group B, and Group C were 110, 16, and 29 min respectively. Oral hygiene scores through modified Turskey Gilmore plaque index which was taken at immediate postoperative, 15, 30, and at 45 days. Maximum hygiene was maintained in intermaxillary fixation screw group followed by modified arch bar group and conventional arch bar group. Maximum stability was seen in the conventional arch bar group followed by modified arch bar group and intermaxillary fixation screw group. With respect to mucosal coverage, maximum mucosal growth was seen in intermaxillary fixation screws group. When complications were taken into consideration, maximum complications were reported in Group A followed by Group B and Group C. Conclusion This study emphasizes that the use of modified arch bar is quick and easy method than conventional arch bar with least chances of glove puncture and needle stick injury to the operator. Oral hygiene maintenance is comparatively better in patients with modified arch bar than with conventional arch bars. Modified arch bar was significantly stable when compared with IMF screws, and therefore, for the patients who require long-term intermaxillary fixation, modified arch bars can be a viable option.
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Affiliation(s)
- Tushar Manohar Rothe
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Akola, India
| | - Prachur Kumar
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Vadodara, India
| | - Navin Shah
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Paldi, India
| | - Rakesh Shah
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Vadodara, India
| | - Amit Mahajan
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Vadodara, India
| | - Ananth Kumar
- Oral and Maxillofacial Surgery, K M Shah Dental College Piparia, Vadodara, Gujarat India
- Vadodara, India
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FAMI Screws for Mandibulo-Maxillary fixation in mandibular fracture treatment - Clinico-radiological evaluation. J Craniomaxillofac Surg 2018; 46:566-572. [PMID: 29459185 DOI: 10.1016/j.jcms.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 12/14/2017] [Accepted: 01/15/2018] [Indexed: 11/22/2022] Open
Abstract
Mandibulo-maxillary fixation (MMF) is indispensable for mandibular fracture treatment. Various means for MMF have been proposed, of which arch bars are widely considered to be the mainstay. However, disadvantages to this method have initiated a quest for an alternative, leading to the introduction of MMF screws. MMF screws have frequently been criticized for poor stability of fracture sites, root damage, hardware failure, and nerve damage. We retrospectively evaluate the FAMI (Fixation and Adaptation in Mandibular Injuries) screw in mandibular fracture treatment by scanning for clinically and radiologically visible complications. In total, 534 FAMI screws were used in the successful treatment of 96 males and 34 females. Condylar fractures were most commonly encountered, representing 120 of 241 fracture sites. 15 general fracture-related complications occurred, with the most common being nerve function impairment (3.8%) and postoperative malocclusion (4.6%). In nine cases (7%), clinically visible FAMI-screw-related complications occurred, with the most prevalent being screw loosening (2.3%) and mucosal signs of inflammation (3.1%). Duration of FAMI screws was associated with the occurrence of clinically visible complications (p = 0.042). Radiologically, clinically invisible dental hard tissue damage was noted in 21 individuals (16%). Therefore, FAMI screws seem to be a reliable and safe method for mandibulo-maxillary fixation.
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Rothe TM, Kumar P, Shah N, Shah R, Kumar A, Das D. Evaluation of efficacy of intermaxillary fixation screws versus modified arch bar for intermaxillary fixation. Natl J Maxillofac Surg 2018; 9:134-139. [PMID: 30546226 PMCID: PMC6251282 DOI: 10.4103/njms.njms_16_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: This study aimed to evaluate the efficacy of intermaxillary fixation (IMF) screws and modified arch bar. Materials and Methods: This study is a randomized clinical trial in which all participants were divided into two groups of ten in each group and designated as Group A and Group B. In Group A, IMF was achieved by the use of four to six 2×8mm stainless steel IMF screws. In Group B, IMF was achieved by modified screw arch bar. Results: In the present study, a total of twenty patients were analyzed. The average working time for Group A and Group B was 16 min and 29 min, respectively. Oral hygiene scores through modified Turesky Gilmore plaque index were calculated at immediate postoperative period and after 15 days, 30 days, and 45 days. Maximum hygiene was maintained in IMF screw group than modified arch bar group, but maximum stability was observed in the modified arch bar group than IMF screw group. Conclusion: This study emphasizes the use of IMF screws as a quick and easy method than modified arch bar. Oral hygiene maintenance was comparatively better in patients with IMF screws than those with modified arch bar. Modified arch bar was significantly stable when compared with IMF screws; therefore, for patients who require long-term IMF, modified arch bars can be a viable option, but the perforation in the original arch bar may lead to the weakening of the arch bar, and therefore the prefabricated modified arch bar would be a better option.
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Affiliation(s)
- Tushar Manohar Rothe
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
| | - Prachur Kumar
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
| | - Navin Shah
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
| | - Rakesh Shah
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
| | - Ananth Kumar
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
| | - Devika Das
- Department of Oral and Maxillofacial Surgery, K.M. Shah Dental College, Vadodara, Gujarat, India
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Kumar P, Menon G, Rattan V. Erich arch bar versus hanger plate technique for intermaxillary fixation in fracture mandible: A prospective comparative study. Natl J Maxillofac Surg 2018; 9:33-38. [PMID: 29937656 PMCID: PMC5996650 DOI: 10.4103/njms.njms_63_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction: Various methods have been described for intermaxillary fixation (IMF) for treatment of faciomaxillary injuries. Many studies have been described to evaluate the efficacy of different methods. Hanger plate method has not been commonly used. The aim of the present study was to compare the advantages and disadvantages of this method over Erich arch bar in mandibular fracture. Materials and Methods: Sixty patients of only mandibular fracture presenting to trauma center requiring open reduction and internal fixation under general anesthesia were randomly allocated to Group A and Group B comprising thirty patients in each. Group A included patients who received IMF with Erich arch bar. Group B included patients who received IMF with hanger plate method. The two groups were compared for time duration of intermaxillary procedure, total duration of surgery, oral hygiene score, postoperative occlusion, and complications. Results: The average time of intermaxillary procedure, total duration of surgery, and wire prick injuries were more in Group A. Oral hygiene score was significantly better in Group B. Postoperative occlusion was comparable between the two groups. There was screw loosening in four patients in Group B, but none had tooth root injury. The cost of material for IMF was more in Group B. Conclusion: IMF with hanger plate method is more safe and efficacious compared to Erich arch bar in the treatment of mandibular fractures.
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Affiliation(s)
- Parmod Kumar
- Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Govind Menon
- Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vidya Rattan
- Department of OHSC, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y. Self-tapping Intermaxillary Fixation Screw: An Alternative to Arch Bar. J Contemp Dent Pract 2017; 18:147-151. [PMID: 28174369 DOI: 10.5005/jp-journals-10024-2006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The use of intermaxillary fixation (IMF) in the treatment of faciomaxillary fractures is the key factor for reduction and immobilization. Various techniques of IMF have been described in the past and recently IMF screws have been introduced. This technique has various advantages, including ease of use, less time consumption, less trauma to the surrounding soft tissues, and relatively reduced risk of needle stick injury. This study evaluates the efficacy of IMF screws over arch bar IMF before definitive fixation of facial fractures. MATERIALS AND METHODS This study is a randomized clinical study. Study population consists of 20 patients with mandibu-lar fractures requiring IMF with open reduction and reported to Department of Oral Surgery, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India between September 2012 and April 2015. Two groups were formed with 10 patients in each group. In the first group, IMF was achieved using the Erich's arch bar and wires. In the second group, IMF was achieved using self-tapping IMF screw. The patients were assessed for various parameters, such as the time required in minutes for the IMF stability of fixation, postoperative occlusion, postoperative pain, periodontal health, oral hygiene, and incidence of needle stick injury. RESULTS All the cases had stable IMF in both groups. At the end of 14th day, overall oral hygiene was poor in group I and good in group II, significant statistically (p = 0.031). Iatrogenic injury to tooth was absent in group I and present in 1 case in group II, not significant statistically (p = 0.305). Average time taken for the IMF in group I was 74.9 minutes, with the range of 58 to 88 minutes, and in group II was 16.1 minutes, with the range of 11 to 22 minutes, which is highly significant statistically (p = 0.001). Needle stick injuries were taken as positive if glove perforation was present and these were reported in four cases in group I, whereas in group II, no case had incidence of needle stick injuries, which shows significant statistically (p = 0.025). CONCLUSION After this study, we can conclude that IMF self-tapping screw is a proven useful technique of IMF. Intermaxillary fixation is a safe and less time-consuming method but with various shortcomings and complications, which the surgeon must be aware of while providing treatment. CLINICAL SIGNIFICANCE Keywords: Erich's arch bar, Intermaxillary fixation, Self-tapping intermaxillary fixation screws.
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Affiliation(s)
- Animesh Barodiya
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rishi Thukral
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India, Phone: +919406536836, e-mail:
| | - S M Agrawal
- Department of Oral and Maxillofacial Surgery, Modern Dental College & Research Centre, Indore, Madhya Pradesh, India
| | - Anil S Chouhan
- Department of Oral and Maxillofacial Surgery, Modern Dental College & Research Centre, Indore, Madhya Pradesh, India
| | - Sidharth Singh
- Department of Oral and Maxillofacial Surgery, Hitkarni Dental College & Hospital, Jabalpur, Madhya Pradesh, India
| | - Yogesh Loksh
- Department of Dentistry, Amaltas Institute of Medical Sciences Dewas, Madhya Pradesh, India
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Hartwig S, Boettner A, Doll C, Voss JO, Hertel M, Preissner S, Raguse JD. Drill-related root injury caused by intraoperative intermaxillary fixation: an analysis of 1067 screw applications. Dent Traumatol 2016; 33:45-50. [PMID: 27681036 DOI: 10.1111/edt.12305] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Intermaxillary fixation is a standard procedure for the treatment of mandibular fractures or in orthognathic surgery. Predrilling for screws poses the risk of accidental tooth root injury, potentially leading to further pathological processes. Limited evidence about accidental tooth injury during intermaxillary fixation is available due to heterogenous study designs. The aim of this study was to evaluate the risk of root trauma using predrilled transgingival fixation screws and the clinical consequences for the affected teeth. MATERIALS AND METHODS In this retrospective study, the data of open reduction and internal fixation surgery files with intraoperative application of predrilled intermaxillary fixation screws were analysed. The postoperative radiographic images were evaluated for the occurrence of tooth root injury. Patients diagnosed with root injury were clinically followed up with respect to the dental health for the affected teeth. RESULTS A total of 133 radiologically diagnosed tooth root injuries were recorded (12.5% of screws). The median follow-up interval was 16 months (range: 3-77 months). The return rate was 49.5% for all patients. Of these, four of the injured teeth (3%) needed endodontic treatment. No toothache was reported, no tooth was lost, and no negative impact on periodontal health was clinically evident. CONCLUSION Intermaxillary fixation with predrilled transgingival screws is a safe way to manage mandibular fractures. The incidence of tooth root injury is not uncommon, but the adverse side effects are rare and the health of the affected teeth is mostly not compromised.
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Affiliation(s)
- Stefan Hartwig
- Department of Oral and Maxillofacial Surgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Boettner
- Department of Biometry and Clinical Epidemiology, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan O Voss
- Department of Oral and Maxillofacial Surgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Moritz Hertel
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Operative and Preventive Dentistry, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan D Raguse
- Department of Oral and Maxillofacial Surgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Qureshi AA, Reddy UK, Warad NM, Badal S, Jamadar AA, Qurishi N. Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: A comparative study and review of literature. Ann Maxillofac Surg 2016; 6:25-30. [PMID: 27563602 PMCID: PMC4979336 DOI: 10.4103/2231-0746.186129] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Various techniques have been employed from time to time to achieve maxillomamdibular fixation. Although arch bars provide an effective and versatile means of maxillomandibular fixation, their use is not without shortcomings. However the introduction of intermaxillary fixation screws (IMF) has eliminated many of these issues of arch bars. The aim of the present study was to compare the advantages and disadvantages of intermaxillary fixation screws over the Erich arch bars in mandibular fractures. Materials and Methods: Sixty dentulous patients who reported to Department of Oral and Maxillofacial Surgery, Al-Ameen Dental College and Hospital, Bijapur with mandibular fractures and required intermaxillary fixation as a part of treatment plan followd by open reduction and internal fixation under GA were selected and randomly divided into 2 groups of 30 patients each that is Group A and Group B. Group A included patients who received intermaxillary fixation with Erich arch bars. Group B includes patients who received intermaxillary fixation with IMF Screws. The parameters compared in both the groups included, surgical time taken, gloves perforation, post-operative occlusion, IMF stability, oral hygiene, patient acceptance and comfort and non-vitality characteristics. Results: The average surgical time taken and gloves perforations were more in Group A,the patient acceptance and oral hygiene was better in Group B, there was not much statistically significant difference in postoperative occlusion and IMF stability in both groups. Accidental root perforation was the only limitation of IMF screws. Conclusion: Intermaxillary fixation with IMF screws is more efficacious compared to Erich arch bars in the treatment of mandibular fractures.
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Affiliation(s)
- Ahtesham Ahmad Qureshi
- Department of Oral and Maxillofacial Surgery, MIDSR Dental College, Latur, Maharashtra, India
| | - Umesh K Reddy
- Department of Oral and Maxillofacial Surgery, Oxford Dental College, Bengaluru, Karnataka, India
| | - N M Warad
- Department of Oral and Maxillofacial Surgery, Al-Ameen Dental College, Bijapur, Karnataka, India
| | - Sheeraz Badal
- Department of Oral and Maxillofacial Surgery, MIDSR Dental College, Latur, Maharashtra, India
| | - Amjad Ali Jamadar
- Department of Orthopedics, MIMSR Medical College, Latur, Maharashtra, India
| | - Nilofar Qurishi
- Department of Oral and Maxillofacial Surgery, MIDSR Dental College, Latur, Maharashtra, India
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Andrei Florescu V, Kofod T, Pinholt EM. Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures-A Retrospective Study. J Oral Maxillofac Surg 2016; 74:1800-6. [PMID: 27206626 DOI: 10.1016/j.joms.2016.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of the present retrospective study was to investigate the morbidity of screws used for intermaxillary fixation (IMF) in the treatment of mandibular fractures. A review of the published data was also performed for a comparison of outcomes. Our hypothesis was that the use of screws for IMF of mandibular fractures would result in minimal morbidity. MATERIALS AND METHODS Patients treated for mandibular fractures from 2007 to 2013, using screws for IMF, using the international diagnosis code for mandibular fracture, DS026, were anonymously selected (Department of Oral and Maxillofacial Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark). The fracture type, radiographic findings, treatment modality, screw type and number, and root damage were recorded. For the outcome comparison, a review of the published data regarding iatrogenic dental root damage caused by screw fixation was performed in May 2015. RESULTS A total of 156 patients had undergone IMF with screws. The total number of screws was 793. The incidence of root lesions was 0.25% centrally and 0.88% peripherally. The incidence of screw loss was 0.13% and that of screw loosening was 1.89%. In the review, 737 related reports were identified in a search of PubMed and the Cochrane Library. Of these, 25 were considered suitable for inclusion. A lack of valid evidence resulted in a descriptive analysis, because a meta-analysis of the data was not possible. CONCLUSIONS The results of the present retrospective study have shown that the use of screws is a valid choice for IMF in mandibular fracture treatment with minimal morbidity. The 793 screws used for IMF resulted in a negligible amount of central and peripheral tooth root trauma.
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Affiliation(s)
- Vlad Andrei Florescu
- PhD Fellow, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Thomas Kofod
- Department Head and Consultant Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Else Marie Pinholt
- Professor, University of Southern Denmark, Faculty of Health Sciences, Institute for Regional Health Sciences, University of Southern Denmark Hospitals, Hospital of South West Denmark, Esbjerg, Denmark
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Falci SG, Douglas-de-Oliveira DW, Stella PEM, Santos CRRD. Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review. Med Oral Patol Oral Cir Bucal 2015; 20:e494-9. [PMID: 26034929 PMCID: PMC4523263 DOI: 10.4317/medoral.20448] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 03/25/2015] [Indexed: 11/11/2022] Open
Abstract
Background Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. Material and Methods An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed. Results Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials. Conclusions There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fractures. Key words:
Facial injuries, jaw fixation techniques, mandible, maxilla.
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van den Bergh B, Blankestijn J, van der Ploeg T, Tuinzing D, Forouzanfar T. Conservative treatment of a mandibular condyle fracture: Comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial. J Craniomaxillofac Surg 2015; 43:671-6. [DOI: 10.1016/j.jcms.2015.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 03/14/2015] [Accepted: 03/16/2015] [Indexed: 11/16/2022] Open
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Bins A, Oomens MAE, Boffano P, Forouzanfar T. Is There Enough Evidence to Regularly Apply Bone Screws for Intermaxillary Fixation in Mandibular Fractures? J Oral Maxillofac Surg 2015; 73:1963-9. [PMID: 25930955 DOI: 10.1016/j.joms.2015.03.072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/24/2015] [Accepted: 03/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Intermaxillary fixation (IMF) is traditionally achieved with arch bars; however, this method has several well-known disadvantages and other techniques, such as bone screws, are available. This study evaluated current evidence regarding these IMF screws (IMFSs) for mandibular trauma and to assess whether this allows a change of treatment protocol for IMF. MATERIALS AND METHODS A systematic electronic literature search was conducted in the PubMed, Embase, and Cochrane databases. Titles and abstracts retrieved from the search were screened and evaluated for inclusion and exclusion criteria. The full text of all relevant articles was read and citation lists were checked for any missing references. All randomized controlled trials (RCTs) were subjected to a quality assessment. Included articles were checked for outcome measurements concerning occlusion, operative time, oral hygiene, root trauma, wire-stick injuries, and mucosa overgrowth. RESULTS Twenty-two articles (17 case series, 4 RCTs, and 1 cohort study) were included. None of the RCTs scored high methodologic results in the quality assessment. The results suggest IMFSs have similar malocclusion rates as arch bars, fewer wire-stick injuries, improved oral hygiene, and shorter operative time. Root damage is less likely to occur with self-drilling screws and seldom requires treatment. CONCLUSIONS Although the methodologic quality of the included studies is poor, self-drilling IMFSs are recommended for temporary per-operative IMF of noncomminuted mandibular fractures. More high-quality studies are required to allow an evidence-based change of protocol.
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Affiliation(s)
- Arjan Bins
- Ph.D. Student, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Marjolijn A E Oomens
- Resident, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
| | - Paolo Boffano
- Research Associate, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
| | - Tymour Forouzanfar
- Head, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
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Son S, Kim SS, Son WS, Kim YI, Kim YD, Shin SH. Miniscrews versus surgical archwires for intermaxillary fixation in adults after orthognathic surgery. Korean J Orthod 2015; 45:3-12. [PMID: 25667912 PMCID: PMC4320316 DOI: 10.4041/kjod.2015.45.1.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/05/2014] [Accepted: 07/21/2014] [Indexed: 12/11/2022] Open
Abstract
Objective We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. Methods All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery (T0), (b) 3 months after surgery (T1), and (c) 6 months after surgery (T2). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t-test procedure was used to compare the two groups. Results After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from T0 to T1, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). Conclusions This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.
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Affiliation(s)
- Sieun Son
- Department of Orthodontics, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Seong Sik Kim
- Department of Orthodontics, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Woo-Sung Son
- Department of Orthodontics, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Yong-Il Kim
- Department of Orthodontics, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Yong-Deok Kim
- Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea
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Tracy K, Gutta R. Are Embrasure Wires Better Than Arch Bars for Intermaxillary Fixation? J Oral Maxillofac Surg 2015; 73:117-22. [PMID: 25511963 DOI: 10.1016/j.joms.2014.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 08/01/2014] [Accepted: 08/15/2014] [Indexed: 11/25/2022]
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Queiroz CS, Sarmento VA, de Azevedo RA, de Oliveira TFL, Bastos LC. A comparative study of internal fixation and intermaxillary fixation on bone repair of mandibular fractures through radiographic subtraction. J Craniomaxillofac Surg 2014; 42:e152-6. [DOI: 10.1016/j.jcms.2013.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 06/03/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022] Open
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Ingole PD, Garg A, Shenoi SR, Badjate SJ, Budhraja N. Comparison of intermaxillary fixation screw versus eyelet interdental wiring for intermaxillary fixation in minimally displaced mandibular fracture: a randomized clinical study. J Oral Maxillofac Surg 2014; 72:958.e1-7. [PMID: 24642133 DOI: 10.1016/j.joms.2014.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/07/2014] [Accepted: 01/07/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw (IMFS) versus eyelet interdental wiring for intermaxillary fixation (IMF) in minimally displaced mandibular fractures. MATERIALS AND METHODS A total of 50 patients with a minimally displaced mandibular fracture were enrolled, with 25 patients randomly selected for each group. In group I (study group, n = 25), the patients were treated using IMFS, and in group II (control group, n = 25), they received eyelet interdental wiring. Both techniques were assessed for the following parameters: time required for placement and removal of each type of IMF technique, time required for placement of IMF wires, postoperative occlusion, stability of the IMF wire, local anesthesia requirement during removal of each fixation type, oral hygiene status, glove perforation rate, and complications associated with both techniques. The collected data were analyzed using Student's unpaired t test or χ2 test. P < .05 was considered significant and the Statistical Package for Social Sciences software, version 10, was used for analysis. RESULTS The average time required for placement in groups I and II was 17.56 and 35.08 minutes, respectively (P = .000). The time required for placement of the IMF wire in group I was 2.1 minutes and in group II was 6 minutes. The oral hygiene status was assessed, and the mean plaque index score for groups I and II was 1.44 and 2.12, respectively (P = .00). The glove perforation rate was much less in group I than in group II. Finally, the most common complication in both groups was mucosal growth. CONCLUSIONS The results established the supremacy of IMFS compared with eyelet interdental wiring. Thus, we have concluded that IMFS, in the present scenario, is a safe and time-saving technique. IMFS is a cost-effective, straightforward, and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF, with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures. In addition, oral hygiene can be maintained, and the glove perforation rate was very low using IMFS. The relatively small sample size and limited follow-up period were the study limitations.
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Affiliation(s)
- Pranav D Ingole
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, Vidya Shikshan Prasarak Mandal Dental College and Research Centre, Nagpur, Maharashtra, India.
| | - Anoop Garg
- Professor, Department of Oral and Maxillofacial Surgery, Vidya Shikshan Prasarak Mandal Dental College and Research Centre, Nagpur, Maharashtra, India
| | - S Ramakrishna Shenoi
- Professor and Head, Department of Oral and Maxillofacial Surgery, Vidya Shikshan Prasarak Mandal Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Samprati J Badjate
- Associate Professor, Department of Oral and Maxillofacial Surgery, Vidya Shikshan Prasarak Mandal Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Nilima Budhraja
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, Vidya Shikshan Prasarak Mandal Dental College and Research Centre, Nagpur, Maharashtra, India
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Delbet-Dupas C, Pham Dang N, Mondié JM, Barthélémy I. [Intermaxillary intraoperative fixation of mandibular fractures: arch bars or fixation screws?]. ACTA ACUST UNITED AC 2013; 114:315-21. [PMID: 24007800 DOI: 10.1016/j.revsto.2013.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 01/24/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The gold standard management of mandibular fractures is open reduction and osteosynthesis associated with intermaxillary fixation. The use of intermaxillary fixation screws for 20 years has considerably reduced the number of intermaxillary fixation with arch bars. The aim of our review was to identify current indications and contraindications of each technique. INTERMAXILLARY FIXATION TECHNIQUES We present a short history and compare the two techniques with recently published assets, drawbacks, and complications. DISCUSSION The indications of intermaxillary fixation screws are uni- or bifocal fractures without or with minimal displacement. Their use is contraindicated in any other type of fracture, which should still be treated with arch bar fixation.
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Affiliation(s)
- C Delbet-Dupas
- Service de chirurgie maxillo-faciale et stomatologie, service de chirurgie plastique et reconstructrice de la face, CHU Estaing, 1, place Lucie-Aubrac, 63000 Clermont-Ferrand, France.
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Design and Application of Hybrid Maxillomandibular Fixation for Facial Bone Fractures. J Craniofac Surg 2013; 24:1801-5. [DOI: 10.1097/scs.0b013e3182a21163] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kumar YR, Chaudhary Z, Sharma P. Spiral intermaxillary fixation. Craniomaxillofac Trauma Reconstr 2013; 5:97-8. [PMID: 23730425 DOI: 10.1055/s-0032-1313361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 03/15/2012] [Indexed: 10/28/2022] Open
Abstract
Intermaxillary fixation (IMF) remains an important component in the management of many facial fractures. During IMF, dental occlusion plays an important role as a guide and therapeutic tool. Since time immemorial there is a constant quest of oral and maxillofacial surgeons to find a quick way for IMF. The desire to develop an alternate interdental fixation technique, which not only would decrease the risk to the operator and gingival trauma but also accurately satisfy dental occlusion, lead to the development of this novel technique of "spiral IMF."
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Affiliation(s)
- Yuvika Raj Kumar
- Oral & Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Alves M, Baratieri C, Araújo M, Souza M, Maia L. Root damage associated with intermaxillary screws: a systematic review. Int J Oral Maxillofac Surg 2012; 41:1445-50. [DOI: 10.1016/j.ijom.2012.05.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 03/13/2012] [Accepted: 05/16/2012] [Indexed: 11/26/2022]
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Schulte-Geers M, Kater W, Seeberger R. Root trauma and tooth loss through the application of pre-drilled transgingival fixation screws. J Craniomaxillofac Surg 2012; 40:e214-7. [DOI: 10.1016/j.jcms.2011.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 10/07/2011] [Accepted: 10/10/2011] [Indexed: 10/15/2022] Open
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Ahmed V KS, Rooban T, Krishnaswamy NR, Mani K, Kalladka G. Root damage and repair in patients with temporary skeletal anchorage devices. Am J Orthod Dentofacial Orthop 2012; 141:547-55. [DOI: 10.1016/j.ajodo.2011.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 11/01/2011] [Accepted: 11/01/2011] [Indexed: 11/16/2022]
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Rai A, Datarkar A, Borle RM. Are Maxillomandibular Fixation Screws a Better Option Than Erich Arch Bars in Achieving Maxillomandibular Fixation? A Randomized Clinical Study. J Oral Maxillofac Surg 2011; 69:3015-8. [DOI: 10.1016/j.joms.2010.12.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 10/25/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Cornelius CP, Ehrenfeld M. The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature. Craniomaxillofac Trauma Reconstr 2011; 3:55-80. [PMID: 22110819 DOI: 10.1055/s-0030-1254376] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines.
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Affiliation(s)
- Carl-Peter Cornelius
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
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Management of paediatric mandibular condylar fractures with screw-based semi-rigid intermaxillary fixation. Int J Oral Maxillofac Surg 2011; 41:55-60. [PMID: 22014681 DOI: 10.1016/j.ijom.2011.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 07/06/2011] [Accepted: 09/20/2011] [Indexed: 11/23/2022]
Abstract
This study was designed to evaluate the feasibility and safety of screw-based semi-rigid intermaxillary fixation (IMF) combined with a specially designed occlusal splint in the conservative treatment of paediatric mandibular condylar fractures. Thirteen paediatric patients with 20 sides of condylar fractures treated with semi-rigid IMF were analyzed retrospectively. Semi-rigid IMF was achieved by inserting self-drilling IMF screws into the anterior alveolar bone of the maxilla and mandible suspended with elastic bands. An occlusal splint with a molar fulcrum was used for functional repositioning of the condylar fragment. After 4 weeks, the screws and occlusal splint were removed. During a mean period of 28.6 months' follow-up, the patients' maximal mouth opening increased to a mean of 37.69 mm. Clinical and radiological examinations revealed satisfactory results in facial symmetry and condylar remodelling. No clinical symptoms or radiographic evidence showed dental injuries associated with screw insertion. This study suggests that this method might be a safe, easy, and effective management of paediatric condylar fractures.
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Adachi M, Matsui Y, Iwai T, Hirota M, Uezono M, Masuda G, Maegawa J, Tohnai I. Epithelial Inclusion Cyst After Intermaxillary Screw Placement: A Case Report. J Oral Maxillofac Surg 2011; 69:1117-9. [DOI: 10.1016/j.joms.2010.02.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 11/20/2009] [Accepted: 02/23/2010] [Indexed: 11/24/2022]
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Hashemi HM, Parhiz A. Complications using intermaxillary fixation screws. J Oral Maxillofac Surg 2011; 69:1411-4. [PMID: 21216063 DOI: 10.1016/j.joms.2010.05.070] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 02/10/2010] [Accepted: 05/07/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE The most important part of facial bone fracture treatment is immobilization. Bandaging of the fractured mandible was the first immobilization device used in ancient Greece. Since then, various methods with different shapes and uses were introduced in the treatment of maxillofacial trauma patients. Intermaxillary fixation (IMF) with bone screws was first used in 1981. This technique has advantages, including quickness, ease of use, less trauma, and reduced risk of needle-stick injury. We analyze the advantages and disadvantages of this technique. METHODS AND MATERIALS In a retrospective study on 73 patients requiring IMF, the complications of IMF screws were analyzed. Complications were divided into 2 groups: dental and nondental. Follow-up examinations consisted of clinical and panoramic radiographic examinations. RESULTS In 24 teeth (6.5%) in 13 patients (17.8%), dental complications occurred. No dental treatment was needed in 4 patients (5.5%). The site at which dental complications occurred during operation in the majority of cases was the anterior mandible. Nondental complications occurred in 63 screws (16.9%) in 39 patients (54.2%). The most common complication was screw loosening. Screw soft tissue coverage occurred in 21 screws. CONCLUSION The use of IMF screws is simple and decreases the time required for surgery, but because of their complications, they still require punctuality.
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Lee CH, Kim CH. Open reduction of mandibular fracture without maxillomandibular fixation: retrospective study. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.4.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Chung-Hyun Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Choenan, Korea
| | - Chul-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Choenan, Korea
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41
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Two-dimensional radiographic and clinical references of the tooth crown for orthodontic mini-implant insertion: A guide-free technique. ACTA ACUST UNITED AC 2010; 110:e8-16. [DOI: 10.1016/j.tripleo.2010.05.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Revised: 05/24/2010] [Accepted: 05/24/2010] [Indexed: 11/20/2022]
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Development of a regional database for studying epidemiology of maxillofacial trauma. J Craniofac Surg 2010; 21:1045-50. [PMID: 20613554 DOI: 10.1097/scs.0b013e3181e62c94] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This article discusses the development of the first regional computerized database for the epidemiological evaluation of maxillofacial trauma and tests its usefulness by evaluating the appropriateness and completeness of the resulting information.The database was developed using Microsoft Access, implemented using Visual Basic. Data were entered in the database by 4 different maxillofacial specialists, one from each of the 4 main regional hospitals where maxillofacial trauma is treated. Clinical information was taken from 100 complete records of patients hospitalized for maxillofacial fractures at the Maxillofacial Division of San Giovanni Battista Hospital in Turin from January to June 2009.Thirteen database fields were used: general information, cause and mechanism of injury, fracture site, Facial Injury Severity Scale, head and neck examination, associated injuries, timing and type of surgery, and days of hospitalization.Overall, the data entered were 99.45% complete and 99.5% accurate. Thus, our regional maxillofacial database can be considered complete and accurate. Some of the errors, mainly in the fields "fracture site" and "Facial Injury Severity Scale," were attributable to an incorrect interpretation of facial fracture diagnoses, based on the medical records that were provided.
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Dao V, Renjen R, Prasad HS, Rohrer MD, Maganzini AL, Kraut RA. Cementum, pulp, periodontal ligament, and bone response after direct injury with orthodontic anchorage screws: a histomorphologic study in an animal model. J Oral Maxillofac Surg 2009; 67:2440-5. [PMID: 19837314 DOI: 10.1016/j.joms.2009.04.138] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 04/10/2009] [Accepted: 04/28/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the histologic response of the periodontium, cementum, and pulp after intentional root injury with titanium screws. MATERIALS AND METHODS Three female beagle dogs were used, and a total of 60 self-drilling/self-tapping miniscrews were manually inserted into the maxilla and the mandible with the intention of placement in close proximity or in direct contact with the roots. Digital radiographs were taken to select the sites with root injuries. After a 3-month period, the animals were killed and serial nondecalcified histologic sections were obtained with the miniscrew in place. RESULTS Sixteen sites with significant root injury were identified. Four sites presented with cementum abrasion, 7 sites had dentin penetration up to 50% of the diameter of the screw, and 5 sites had miniscrew penetration into the pulp space with root fragmentation. At all damaged sites, continuous cementum repair could be observed. There was no evidence of external resorption or pulpal necrosis and/or inflammatory infiltrate. Point ankylosis was seen only in cases of severe injury with root fragmentation. Finally, woven bone was present along the miniscrew threads. CONCLUSION When titanium screws penetrate root cementum or dentin, pulpal necrosis and/or inflammation was not observed at 12 weeks in an animal model. Cementum regenerates at every injury site, but ankylosis can occur with root fragmentation. Woven bone is present at the screw-bone interface even with root contact suggesting osteointegration.
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Affiliation(s)
- Volong Dao
- Department of Dentistry, Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, Bronx, NY, USA
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Rossouw PE, Buschang PH. Temporary orthodontic anchorage devices for improving occlusion. Orthod Craniofac Res 2009; 12:195-205. [DOI: 10.1111/j.1601-6343.2009.01453.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Result of Maxillomandibular Fixation Using Intraoral Cortical Bone Screws for Condylar Fractures of the Mandible. J Oral Maxillofac Surg 2009; 67:767-70. [DOI: 10.1016/j.joms.2008.06.055] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Revised: 01/20/2008] [Accepted: 06/16/2008] [Indexed: 11/22/2022]
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Brisceno CE, Rossouw PE, Carrillo R, Spears R, Buschang PH. Healing of the roots and surrounding structures after intentional damage with miniscrew implants. Am J Orthod Dentofacial Orthop 2009; 135:292-301. [DOI: 10.1016/j.ajodo.2008.06.023] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 06/09/2008] [Accepted: 06/09/2008] [Indexed: 11/30/2022]
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Self-tapping and self-drilling screws for intermaxillary fixation in management of mandibular fractures. J Craniofac Surg 2009; 20:68-70. [PMID: 19164992 DOI: 10.1097/scs.0b013e318190df2f] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The current study evaluated the success and the possible complication of intermaxillary fixation with self-tapping and self-drilling screws (STSDSs) in nondislocated or slightly dislocated mandibular fractures.Forty patients with mandibular fractures, treated with intermaxillary fixation using STSDSs, were clinically assessed by means of a dental vitality test and evaluation of tooth mobility adjacent to the cortical screw holes, and radiologically by means of a panoramic dental radiograph upon removal of the screws.The main complication was screw loss in 4.4% of cases, followed by coverage by oral mucosa in 1.2% of cases. However, no dental root damage, screw breakage, malocclusion, or poor consolidation of mandibular fractures was observed.The use of STSDSs for intermaxillary fixation is a useful alternative to the use of arch bars in the treatment of some types of mandibular fractures. In addition, there is no risk of dental lesions as with self-tapping screws.
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Bell RB, Wilson DM. Is the Use of Arch Bars or Interdental Wire Fixation Necessary for Successful Outcomes in the Open Reduction and Internal Fixation of Mandibular Angle Fractures? J Oral Maxillofac Surg 2008; 66:2116-22. [DOI: 10.1016/j.joms.2008.05.370] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2008] [Accepted: 05/27/2008] [Indexed: 10/21/2022]
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Poeschl PW, Ploder O, Seemann R, Poeschl E. Maxillomandibular Fixation Using Intraoral Cortical Bone Screws and Specially Designed Metal Hooks (Ottenhaken) in the Conservative Treatment of Mandibular Fractures. J Oral Maxillofac Surg 2008; 66:336-41. [DOI: 10.1016/j.joms.2007.06.671] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2007] [Revised: 05/23/2007] [Accepted: 06/07/2007] [Indexed: 10/22/2022]
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Coletti DP, Salama A, Caccamese JF. Application of Intermaxillary Fixation Screws in Maxillofacial Trauma. J Oral Maxillofac Surg 2007; 65:1746-50. [PMID: 17719392 DOI: 10.1016/j.joms.2007.04.022] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Accepted: 04/06/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE The use of intermaxillary fixation (IMF) in the treatment of maxillofacial trauma represents the cornerstone of fracture reduction and immobilization. Many modalities of IMF have been described; recently IMF screws have been introduced into clinical practice, however, hardware failure can occur. We performed a retrospective study evaluating hardware-associated complications for self-drilling/tapping IMF screws. MATERIALS AND METHODS A retrospective study on 49 patients requiring IMF was performed. The diagnosis, duration of IMF, screw site, use of elastic or wire fixation, and associated complications were recorded. IMF screws were used to adjunct open reduction techniques, for definitive closed reduction, or fracture prevention following dentoalveolar surgery. Follow-up examinations were performed until fracture healing was complete (6 to 8 weeks). RESULTS A single adverse event occurred in 19 patients (39%) while 4 patients (8%) had more than 1 complication. The most common event was screw loosening; 29% of patients had at least 1 screw dislodged in the treatment period. Of the total number of screws placed (229), 15 (6.5%) became loose, and were equally distributed among the mandible and maxilla. The remaining complications noted were root fracture, 4% (2 of 49); loosened wires, 6% (3 of 49); screw shear, 2% (1 of 49); malocclusion, 2% (1 of 49); and ingested hardware, 2% (1 of 49). CONCLUSIONS Overall the IMF self-drilling/tapping screws have been shown to be a useful modality to establish maxillomandibular fixation. It is a safe, and time-sparing technique; however, it is not without limitations or potential consequences which the surgeon must be aware of in order to provide safe and effective treatment.
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Affiliation(s)
- Domenick P Coletti
- Department of Oral and Maxillofacial Surgery, University of Maryland Medical Center, R. Adams Cowley Shock Trauma Unit, Baltimore College of Dental Surgery, Baltimore, MD 21201, USA.
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