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Daniels JS, Albakry I, Braimah RO, Samara MI, Albalasi RA, Begum F, Al-Kalib MAM. Experience with Airway Management and Sequencing of Repair of Panfacial Fractures: A Single Tertiary Healthcare Appraisal in Najran, Kingdom of Saudi Arabia - A Retrospective Study. Ann Maxillofac Surg 2020; 10:402-408. [PMID: 33708586 PMCID: PMC7943977 DOI: 10.4103/ams.ams_202_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/27/2020] [Accepted: 07/17/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction: Special cooperation is required among surgeons and anesthetists in airway management during repair of panfacial fractures, due to problems of shared airway and occlusion. Several methods have been proposed for airway management and sequencing of repair of panfacial fractures. The main objective of the current study was to share our experience in the airway management and sequencing of repair of panfacial fractures. Methods: This was a retrospective study of panfacial fractures in the Kingdom of Saudi Arabia from January 2008 to December 2018. Data collected included demographics, type of airway management, sequence of repair (as primary variables), and outcome of surgery (secondary variable), while surgeon and anesthetic expertise are confounders. Data were analyzed using IBM SPSS Statistics for Windows Version 25 (Armonk, NY, USA: IBM Corp). Results were presented as simple frequencies and descriptive statistics. Pearson Chi-square was used to compare categorical variables such as airway management and sequencing of repair with the panfacial fractures. Statistical significance was set at P ≤ 0.05. Results: Overall, 1057 patients sustained different categories of maxillofacial bone fractures with 23 females and 1034 males (M:F of 46:1). A total of 43 male patients out of 1057 patients had panfacial fractures during the study period, giving a prevalence rate of 4.1%. Only the 43 male patients with panfacial fractures were analyzed. All cases were as a result of motor vehicular accident. Six (13.9%) patients had tracheostomy while 37 (86.1%) patients had submental intubation. “Bottom-up” and “outside-in” approach was used in 33 (76.7%) patients, while “top-bottom” and “inside-out” approach was used in 10 (23.3%) patients. Discussion: Submental intubation was the major airway management of panfacial fracture, and “bottom-up” and “outside-in” approach was the main sequence of repair in our series. These approaches have been mentioned in the literature. Conclusion: From our study, victims of pan-facial fractures were found to be exclusively male with MVA as the sole etiological factor. Barring severe head injuries, which may necessitate the use of tracheostomy to sustain breathing over a longer period, submental intubation is extremely reliable as a mode of airway management during surgical treatment of panfacial fractures. The sequencing of repair of panfacial fractures can only be determined according to the case presentation rather than a predetermined one.
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Affiliation(s)
- John Spencer Daniels
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Ibrahim Albakry
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Ramat Oyebunmi Braimah
- Department of Oral and Maxillofacial Surgery, Specialty Regional Dental Center, Najran, Kingdom of Saudi Arabia
| | - Mohammed Ismail Samara
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Rabea Arafa Albalasi
- Department Oral and Maxillofacial Surgery, Sharourah General Hospital, Sharourah, Kingdom of Saudi Arabia
| | - Farzana Begum
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
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Management of Mandible Fracture by Plating and Wiring: An Otolaryngologist Perspective at Teritiary Care Center. Indian J Otolaryngol Head Neck Surg 2019; 71:417-424. [PMID: 31741997 DOI: 10.1007/s12070-018-1332-5] [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: 10/08/2017] [Accepted: 03/28/2018] [Indexed: 10/17/2022] Open
Abstract
The facial area is one of the most frequently injured parts of the body (Abiose in Br J Oral Maxillofac Surg 24(1):319, 1986; Adi et al. in Br J Oral Maxillofac Surg 28(3):1949, 1990; Allan and Daly in Int J Oral Maxillofac Surg 19(5):26871, 1990), and the mandible is one of the most commonly fractured maxillofacial bones (1990; Azevedo et al. in J Trauma 45(6):10847, 1998; Bremerich et al. in Acta Stomatol Belg 93:511, 1996). Mandible is the only mobile bone of the skeleton, and hence vulnerable to fracture. This is a retrospective study of 50 mandibular fracture cases managed at the Department of ENT, Govt. Medical College Bhavnagar during the 2 years period from 2014 to 2016. Maximum subjects were in age group 21-30 years with a male preponderance. Road traffic accident is the main cause followed by falls and assault. Symphysis is the most common site of Mandibular fracture. Mandible fracture is a common entity in Road traffic accidents. Multiple fractures are seen in 40% of mandibular fracture cases. The results were equally good in patients requiring only MMF (Maxillo Mandibular Fixation) and inpatients requiring MMF and Plating, during the follow up up to 8 weeks. Physiotherapy was advised for all the post op patients after 2 months.
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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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Abstract
Traumatic panfacial fracture repair is one of the most complex and challenging reconstructive procedures to perform. Several principles permeate throughout literature regarding the repair of panfacial injuries in a stepwise fashion. The primary goal of management in most of these approaches is to restore the occlusal relationship at the beginning of sequential repair so that other structures can fall into alignment. Through proper positioning of the occlusion and the mandibular-maxillary unit with the skull base, the spatial relationships and stability of midface buttresses and pillars can then be re-established. Here, the authors outline the sequencing of panfacial fracture repair for the restoration of anatomical relationships and the optimization of functional and structural outcomes.
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Affiliation(s)
- Kausar Ali
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Salvatore C Lettieri
- Division of Plastic Surgery, Mayo Clinic, Rochester, MN and Plastic Surgery, Maricopa Integrated Health System, Phoenix, Arizona
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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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El-Anwar MW, Sayed El-Ahl MA, Amer HS. Open Reduction and Internal Fixation of Mandibular Fracture without Rigid Maxillomandibular Fixation. Int Arch Otorhinolaryngol 2015; 19:314-8. [PMID: 26491477 PMCID: PMC4593909 DOI: 10.1055/s-0035-1549154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/23/2015] [Indexed: 10/25/2022] Open
Abstract
Introduction The ability to treat fracture with open reduction and internal fixation (OR/IF) has dramatically revolutionized the approach to mandible fracture. With OR/IF, the postoperative role of rigid maxillomandibular fixation (MMF) has declined, but it is used to maintain proper occlusion until internal fixation of the fracture is achieved. Objective To assess intraoperative manual MMF during OR/IF of selected cases of mandibular fractures. Methods This prospective study was conducted on 80 patients with isolated mandibular fractures managed by OR/IF using two titanium miniplates. The patients were classified into two groups: a control group (40 patients) treated by OR/IF after intraoperative rigid MMF followed by immediate MMF removal, and a study group (40 patients) treated by rigid MMF, which was replaced by temporary intraoperative manual MMF (3MF) until plate fixation. Results There were no significant differences of the postoperative complication and dental occlusion, although a highly significant reduction of operative time was achieved in the 3MF group. Patient who received the 3MF technique had statistically significantly better average intrinsic vertical mouth opening in the early postoperative period (1 week after surgery), and normal mouth opening could be achieved in all cases in both groups 8 weeks after surgery. Conclusions Intraoperative rigid MMF is not mandatory and can be replaced in selected cases of fracture mandible by manual maintenance of proper dental occlusion until hardware fixation, gaining the advantages of shorter operative time and less risk of blood-transmitted diseases to the surgical team and the patient in addition to the benefits of immediate postoperative mandible mobilization.
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Affiliation(s)
| | | | - Hazem Saed Amer
- Department of Otorhinolaryngology, Head and Neck Surgery, Zagazig University, Zagazig, Egypt
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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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Vyas A, Mazumdar U, Khan F, Mehra M, Parihar L, Purohit C. A study of mandibular fractures over a 5-year period of time: A retrospective study. Contemp Clin Dent 2014; 5:452-5. [PMID: 25395758 PMCID: PMC4229751 DOI: 10.4103/0976-237x.142808] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: This study aims to evaluate and compare with the existing literature on the etiology, pattern, gender, and anatomical distribution of mandibular fractures. Materials and Methods: The data of 225 cases were analyzed over a period of 5 years between March 2009 and November 2013. Of this 110 were unilateral, 23 bilateral, 18 symphysis and 74 multiple fractures. Results: Males are more affected than females. The peak incidence rate is occurring in 30-35 years of age group. The most common fracture site is parasymphysis and least common site is ramus of mandible. The most common etiological factor is road traffic accident (RTA) (45.3%) followed by falls (42.6%), assaults (8.9%), sport injuries (2.2%), and gunshot wounds (0.89%). Conclusion: Thus, we conclude that RTA is the leading cause of mandibular fractures and males are more affected. The most common site is parasymphysis fracture in association with angle fracture. We observed that gender was significantly associated with body and angle fracture (P = 0.04) and significant relationship between etiology with multiple site fracture such as (parasymphysis-angle), (body-condyle), (body-angle), and (symphysis-condyle) was observed (P ≤ 0.05).
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Affiliation(s)
- Ashish Vyas
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Utpal Mazumdar
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Firoz Khan
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Madhura Mehra
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Laveena Parihar
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Chandni Purohit
- Department of Oral Surgery, Jodhpur Dental College and Hospital, Jodhpur, Rajasthan, India
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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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Leonard Buttons: A Reliable Method of Intraoperative Intermaxillary Fixation in Bilateral Mandibular Fractures. J Oral Maxillofac Surg 2012; 70:1131-8. [DOI: 10.1016/j.joms.2011.10.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 10/18/2011] [Accepted: 10/19/2011] [Indexed: 11/21/2022]
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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: 51] [Impact Index Per Article: 3.9] [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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Kar IB, Mahavoi BR. Retrospective analysis of 503 maxillo-facial trauma cases in odisha during the period of dec'04-nov'09. J Maxillofac Oral Surg 2011; 11:177-81. [PMID: 23730065 DOI: 10.1007/s12663-011-0276-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 08/15/2011] [Indexed: 11/26/2022] Open
Abstract
This study involves mandibular and midface fractures recorded in the trauma reports of OMFS department, SCB dental college, Cuttack, Odisha. The reports were studied between December 2004 and November 2009. The 503 patients had 539 mandibular fractures and 117 midface fractures. Males accounted for 442 (87.87%) and females accounted for 61 (12.12%). Male to female ratio was 7.25:1. The most common cause of fracture was road traffic accident and accounted for 404 (80.31%). The most common site of fracture mandible was parasymphysis where as in middle third fracture it was zygomatic complex fracture. The most common age groups involved in fracture were 21-30 years and the incidence of head injury was 97(19.28%). Many of these variations may be related to socioeconomic, cultural and environmental conditions.
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Affiliation(s)
- Indu Bhusan Kar
- Department of Oral & Maxillofacial Surgery, S.C.B. Dental College & Hospital, Cuttack, Odisha India
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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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A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg 2010; 39:10-5. [DOI: 10.1016/j.ijom.2009.10.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 06/08/2009] [Accepted: 10/13/2009] [Indexed: 11/21/2022]
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Rahpima A, Halaj Mofrad A. The use of maxillomandibular fixation screws with essig wiring in the treatment of symphyseal fracture of deep bite patients. J Maxillofac Oral Surg 2009; 8:375-6. [DOI: 10.1007/s12663-009-0090-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2008] [Accepted: 11/19/2009] [Indexed: 11/24/2022] Open
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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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Vural E, Ragland J, Key JM. Manually provided temporary maxillomandibular fixation in the treatment of selected mandibular fractures. Otolaryngol Head Neck Surg 2008; 138:528-30. [PMID: 18359367 DOI: 10.1016/j.otohns.2007.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 12/10/2007] [Accepted: 12/19/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To report the occlusal outcomes of manually provided temporary intraoperative maxillomandibular fixation (MMMF) for the open repair of selected mandibular fractures. STUDY DESIGN/SUBJECTS AND METHODS: A retrospective chart review of the patients who underwent open reduction and internal fixation of mandibular fractures with MMMF was performed. RESULTS Twenty-six patients underwent open reduction and internal fixation with MMMF. Postoperative data were available for only 16 patients who kept their follow-up appointments. With the exception of one patient who experienced minimal cross-bite in the right molar region, all of the patients had their original normocclusion. CONCLUSION Preliminary results of MMMF suggest that satisfactory postoperative occlusal outcomes may be obtained without the use of wire-based maxillomandibular fixation methods in selected mandibular fractures.
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Affiliation(s)
- Emre Vural
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AK 72205, USA.
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