Comparison of Efficacy of Transalveolar Screws and Conventional Dental Wiring Using Erich Arch Bar for Maxillomandibular Fixation in Mandibular Fractures

Abstract

We found that transalveolar group offered advantages like less time taken with a definite decreased risk of percutaneous injury, while the iatrogenic complications like dental damage can be reduced by taking adequate precautions.

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

“…27,30 This data suggests that there is a high risk of communication of blood borne diseases when arch bar is used for IMF. On the contrary, 4 studies reported mucosal coverage 12,28 –30 and 5 studies reported tooth mobility with the use of IMF screws. 13,27 –30 These complications were not seen when arch bar was used; only 2 teeth crowns were damaged while using arch bar.…”

“…A total of 6 studies have reported about the various complications in both the groups (Table 4). Needle stick injury or glove perforation was reported by 5 studies and was seen in Arch Bar group in all the studies, 12,13,27,29,30 whereas only 2 studies had needle stick injuries or glove perforations in IMF screw group. 27,30 This data suggests that there is a high risk of communication of blood borne diseases when arch bar is used for IMF.…”

“…Needle stick injury or glove perforation was reported by 5 studies and was seen in Arch Bar group in all the studies, 12,13,27,29,30 whereas only 2 studies had needle stick injuries or glove perforations in IMF screw group. 27,30 This data suggests that there is a high risk of communication of blood borne diseases when arch bar is used for IMF. On the contrary, 4 studies reported mucosal coverage 12,28 –30 and 5 studies reported tooth mobility with the use of IMF screws.…”

“…On the contrary, 4 studies reported mucosal coverage 12,28 –30 and 5 studies reported tooth mobility with the use of IMF screws. 13,27 –30 These complications were not seen when arch bar was used; only 2 teeth crowns were damaged while using arch bar. 30 Three studies reported IMF screw loosening 12,28,29 and 2 studies reported IMF screw fracture.…”

“…All the included studies were assessed for their quality by 2 independent reviewers using Cochrane’s risk of bias assessment tool. Out of the 8 included studies, 2 studies had low risk of bias in all the 7 domains 29,30 whereas the other 6 studies showed a high risk of bias. 12,13,26 –28,31 These studies did not provide adequate information on the procedure on randomization, moreover they failed to describe allocation concealment completely.…”