Comparison of Intermaxillary Fixation Screw Versus Eyelet Interdental Wiring for Intermaxillary Fixation in Minimally Displaced Mandibular Fracture: A Randomized Clinical Study

Is There Enough Evidence to Regularly Apply Bone Screws for Intermaxillary Fixation in Mandibular Fractures?

“…The remaining 6 articles described comparable results ranging from 13.0 to 18.67 minutes. 9,10,17,18,23,26 Four studies described the time required for removal of the screws, ranging from 5.8 to 15.0 minutes. 10,13,15,17 …”

“…Eleven studies concerning self-tapping screws adequately described the number of patients, the number and type of screws, root damage, and treatment. 13,15,17,18,[20][21][22]24,[26][27][28] Five studies described the same data for self-drilling screws. 5,8,10,14,28 Table 3 presents these cumulative data, suggesting self-drilling screws have a better safety profile.…”

“…Ingole et al 17 reported that 43 screws (41.3%) were partially or totally covered by mucosa and Rai et al 10 reported comparable results with 92 screws (38.3%) covered by mucosa after 4 weeks of follow-up. 10,17 The remaining 6 studies reported less mucosa overgrowth (range, 1.2 to 6.6%). 5,8,18,21,24,29 Discussion Mandibular fracture treatment can be a timeconsuming procedure with a great deal of discomfort for patients.…”

“…8,23 However, prolonged postoperative traction can be limited owing to premature screw loosening commonly reported in several studies. 5,10,14,17,29 Various studies reported insufficient postoperative traction with IMFSs, sometimes followed by switching to arch bars for the correction of occlusal discrepancies. 18,19,21,22 Loss of fixation and risk of additional surgery still seem to be unfavorable conditions for prolonged IMF with IMFSs.…”

“…6,32 With IMFSs averaging approximately 15 minutes to apply, all studies showed a decrease in operative time compared with the average of 45 minutes for the arch bar appliance. 5,11,17,30 Oral hygiene is easier to maintain when less hardware is covering the teeth, resulting in better oral hygiene scores for IMFSs compared with arch bars or interdental wiring. 10,11,17,33 Although an overall average incidence of 9.0% for root damage was found, only 0.9% of teeth required endodontic treatment or extraction (Table 1).…”