Use Of Intermaxillary Fixation Screws Research Articles

COMPARISON OF CONVENTIONAL ARCH BARS WITH FIXATION SCREWS FOR INTERMAXILLARY FIXATION IN MANDIBULAR FRACTURES: A RANDOMIZED PROSPECTIVE CLINICAL STUDY.

Introduction: Occlusion is the way in which one’s maxillary and mandibular teeth relate to each other when the jaw is closed. When treating fractures of the mandible, the first and primary objective is to re-establish the patient’s premorbid occlusion which is required for the mastication and also the other objective is to achieve esthetics. Inter-maxillary fixation (IMF) plays a vital role in management of fractures involving maxilla and mandible & helps in stabilizing the patient’s occlusion and thus reduction in fracture segments. Many modalities for obtaining intermaxillary fixation like Arch bars, eyelets, interdental wiring, orthodontic braces and intermaxillary fixation screws have been considered. Every method used for intermaxillary fixation has its own merits and demerits. Materials and Method: A prospective randomized clinical study was conducted between 2015 to 2017 in Patients who reported with mandibular fractures to the department of Oral & Maxillofacial Surgery at Vydehi Institute of Dental Sciences and Research Centre. A total of 50 patients with mandibular fractures requiring internal fixation were divided into two groups. Group A consisted of patients in whom Erich’s arch bars were placed for IMF and Group B consisted of patients in whom IMFS were placed for IMF. Patients included were those who required IMF, Subjects in good health i.e; ASA I,II and III. Patients excluded were completely edentulous, ASA IV subjects, Comminuted fractures, Pediatric patients, Panfacial fractures. Results: Use of arch bars as seen in our results has a few disadvantages over IMF screws like time consumed in application and removal is more, Increased pain scores, Increased number of needle stick injuries and difficulty in maintaining oral hygiene, however it has its own advantages like it can be used in the treatment of dentoalveolar fractures, multiple teeth bearing fractured fragments can be reduced into an arch form. Use of IMF screws provide better oral hygiene status as well as same occlusal results as of arch bars. Decreased number of needle stick injuries and takes lesser time to apply and remove. IMF screws are useful in mandibular fractures which are not grossly displaced or comminuted. Conclusion: Use of both the techniques in achieving IMF is efficacious with both the techniques having merits and demerits over each other. Although both the techniques offer good temporary intermaxillary fixation, the benefits and risks of both the techniques should be weighed depending on the type of fracture we are dealing with. Keywords: IMF

Is the Use of Intermaxillary Fixation Screws an Alternative to Erich Arch Bars for Maxillomandibular Fixation During Management of Maxillofacial Fractures? A Systematic Review and Meta-Analysis.

Systematic review and meta-analysis. Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma. An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF. A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable. The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.

A randomized prospective comparison of maxillomandibular fixation (MMF) techniques: “SMARTLock” hybrid MMF versus MMF screws

The aim of this study was to assess the efficacy of the "SMARTLock" hybrid system and determine whether it results in fewer intraoperative and postoperative complications compared with placement of intermaxillary fixation (IMF) screws in trauma patients. This prospective study, which was approved by the institutional review board, compared the results of MMF in mandibular fractures by using the Stryker "SMARTLock" hybrid system versus traditional IMF screws. Patients were recruited and assigned randomly to either group. The 2 groups were compared for placement time, intraoperative complications, loosening of hardware, postoperative complications, and time to device removal. We enrolled 32 patients in the study, with 13 patients randomized to the group receiving hybrid MMF (HMMF) with the SMARTLock system and 19 to the group of patients receiving MMF with traditional IMF screws. The mean application time for HMMF was 25.92 minutes compared with 18.28 minutes for IMF screws. After removal, the HMMF was associated with gingival overgrowth and gingival edema. This is the first study to compare HMMF with MMF with the use of IMF screws. Hybrid arch bars do require more manipulation for ideal placement compared with individually placed bone screws to achieve ideal MMF. Compared with IMF screws, the hybrid device was associated with gingival edema and overgrowth, but there was decreased incidence of loosening in the postoperative period.

Protocol for Single-Stage Bilateral Temporomandibular Joint Replacement Using Intraoperative Navigation in Patients With Ankylosis

Treatment of patients with bilateral temporomandibular joint (TMJ) ankylosis in a single-stage procedure can be challenging. The implementation of intraoperative navigation has proved beneficial by enabling faster and safer excision by providing real-time identification of vital structures. Navigation also can be used to verify site preparation for custom joint prostheses. This article seeks to establish a protocol, based on the use of intermaxillary fixation screws, to produce accurate and repeatable outcomes for the correction of bilateral TMJ ankylosis with total joint replacement in a single-stage procedure.

Evaluation of efficacy of intermaxillary fixation screws versus modified arch bar for intermaxillary fixation.

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.

The use of inter-maxillary fixation screws as denture abutments in a patient with Parkinson's disease

The use of inter-maxillary fixation screws as denture abutments in a patient with Parkinson's disease

Blocage maxillo-mandibulaire peropératoire des fractures de mandibule : arcs ou vis de blocage ?

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. We present a short history and compare the two techniques with recently published assets, drawbacks, and complications. 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.

A novel use of intermaxillary fixation screws for post-maxillectomy obturator retention

a mmediate reconstruction is required following ablative urgery for maxillary tumours. Usual methods include local r free flap reconstruction, or the fabrication of a custom made bturator. Obturators aim to guide soft tissue healing, restore acial contour and achieve a seal between the antral and oral avities. Methods of obturator retention include dental clasps nd hooks, osseointegrated implants and transosseous screws nto remaining palate. Intermaxillary fixation (IMF), or self-drilling monoortical, screws are commonly used to achieve occlusal tability during fixation of facial fractures.1,2 Although complications3,4 have been reported with their se, they are a cheap, readily available and can be easly placed and removed. The most commonly reported omplications are related to damage of the adjacent entition. We present a case in which initial, temporary obturator etention methods failed. IMF screws and wire ligatures were uccessfully used to retain the obturator without further comlication. Following low-level partial maxillectomy for squamous ell carcinoma the patient was reconstructed with a cusom made acrylic obturator and Ufi Gel SC (Voco GmbH) ining. Initial methods of retention included interdental

Complications Using Intermaxillary Fixation Screws

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. 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. 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. The use of IMF screws is simple and decreases the time required for surgery, but because of their complications, they still require punctuality.

Intermaxillary fixation screws in mandibular trauma

Traditional maxillomandibular fixation with arch bar wiring to provide indirect stabilisation of the fractured jaws has long been replaced with miniplate osteosynthesis to reduce the duration of mouth closure. Therefore, a faster, safer and simpler method of maxillomandibular fixation for peri- and intraoperative stabilisation of jaw fractures has been tried as an option using intermaxillary fixation (IMF) screws. This study presents a review of 20 randomly selected cases of mandibular fractures treated by open reduction and internal fixation (ORIF) with miniplate osteosynthesis with peri/intraoperative use of IMF screws made of high resistance stainless steel, the use of which remains undocumented. The favourable results are an increased level of comfort for the operator, reduced working time therefore allowing time more efficient patient care as well as almost omitting the incidence of needle-stick type injuries due to limited use of wires and postoperative removal taking under 2 min in experienced hands. These advantages make it the preferred technique wherever possible, especially in hepatitis B, C and human immunodeficiency virus (HIV)-positive patients. The study is also aimed at sharing the experience in the use of IMF screws in terms of their number, placement and size, etc.

The Use of an Intermaxillary Fixation Screw for Mandibular Setback Surgery

To assess skeletal stability after mandibular setback surgery with and without an intermaxillary fixation (IMF) screw. The subjects were 40 patients with mandibular prognathism. The subjects underwent sagittal split ramus osteotomy with titanium plate fixation and were divided into 2 groups, 1 with and 1 without an IMF screw. A lateral cephalogram was done preoperatively, immediately after surgery, and 1 month, 3 months, and 6 months postoperatively. The 2 groups were then compared statistically. In the comparison of the time-course change between the 2 groups with repeated measure analysis of variance, there were significant differences in occlusal plane (between subjects, F = 2.517; df = 4; P = .0437) and convexity (between subjects, F = 4.048; df = 4; P = .0038). However, there was no significant difference in the other measurements. This study suggested that in most measurements, there was no significant difference between 2 groups with and without an IMF screw in time-course skeletal change. However, use of IMF screws was helpful for orthognathic surgery as a rigid anchor of IMF.