Comparison of intermaxillary fixation techniques for mandibular fractures with focus on patient experience

Abstract

Background: Intermaxillary fixation (IMF) is a technique that allows for the reduction and stabilization of mandibular fractures. Several methods of IMF, such as self-tapping screws or arch bars, have been developed. This study aimed to validate the usefulness of IMF with a self-tapping screw compared to IMF with arch bars with focus on the patients’ perspective.Methods: We retrospectively reviewed the medical records of all patients who were treated for mandibular fractures at our hospital between August 2014 and February 2021. A total of 57 patients were enrolled in this study. Thirteen patients were excluded from the analysis: three patients were lost to follow-up, and 10 patients did not undergo IMF. Finally, 44 patients were analyzed, of which 31 belonged to the arch bar group, and 13 belonged to the screw group. Patient discomfort and pain during IMF application and removal were analyzed using a patient self-assessment questionnaire. The surgeon also assessed oral hygiene, IMF stability, and occlusion.Results: We applied IMF to 34 men (77%) and 10 women (23%). The mean age of the patients was 37.3 years. The most common fracture site was the angle (30%), followed by the parasymphysis (25%), the body (23%), the condyle (11%), and the ramus (11%). Patient discomfort and oral hygiene were statistically favorable in the screw group. The IMF application time was statistically shorter in the screw group (<i>p</i>< 0.001). IMF stability was not statistically different between the two groups. The pain score during IMF removal was lower in the screw group (<i>p</i>< 0.001).Conclusion: Compared to arch bars, IMF screws provide more comfort during the IMF period, help maintain favorable oral hygiene, and have a shorter application time. From the patient’s perspective, IMF screws are an excellent alternative to conventional arch bars when applicable.

Management of Maxillofacial Trauma in Pregnant Women

“…For this reason, ORIF is indicated in the setting of maxillofacial trauma in gravid women. 16,17 While 2 of the cases above recovered without complication, healing was delayed in one case. It was postulated healing was delayed due to pregnancy-induced inflammation and altered immune function.…”

“…However, intermaxillary fixation may affect the masticatory function, which interferes with maternal and fetal nutrition. For this reason, ORIF is indicated in the setting of maxillofacial trauma in gravid women 16,17 . While 2 of the cases above recovered without complication, healing was delayed in one case.…”

March’s 2024 Full Issue PDF

“…11 Also, numerous and distinctive advantages of intermaxillary screws over traditional methods were highlighted in their study. 11 Kim and colleagues (2022) stated that the average time required for screws fixation is 15.38 minutes, 34 what is faster than arch bars fixation to the dentulous arches.…”

Diagnosis of split fractures of the mandible in adults

“…IMF screws have several benefits, including a shorter operation time, simpler procedure, and minimal discomfort for the patient during outpatient removal. Research has shown that IMF screws provide stability and malocclusion rates comparable to traditional arch bars [ 9 ]. There are also reports of using N-2-butyl cyanoacrylate adhesive to correct pediatric zygomatic split fractures [ 10 ].…”