Self-tapping Intermaxillary Fixation Screw: An Alternative to Arch Bar

Abstract

Introduction The use of intermaxillary fixation (IMF) in the treatment of faciomaxillary fractures is the key factor for reduction and immobilization. Various techniques of IMF have been described in the past and recently IMF screws have been introduced. This technique has various advantages, including ease of use, less time consumption, less trauma to the surrounding soft tissues, and relatively reduced risk of needle stick injury. This study evaluates the efficacy of IMF screws over arch bar IMF before definitive fixation of facial fractures. Materials and methods This study is a randomized clinical study. Study population consists of 20 patients with mandibular fractures requiring IMF with open reduction and reported to Department of Oral Surgery, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India between September 2012 and April 2015. Two groups were formed with 10 patients in each group. In the first group, IMF was achieved using the Erich's arch bar and wires. In the second group, IMF was achieved using self-tapping IMF screw. The patients were assessed for various parameters, such as the time required in minutes for the IMF stability of fixation, postoperative occlusion, postoperative pain, periodontal health, oral hygiene, and incidence of needle stick injury. Results All the cases had stable IMF in both groups. At the end of 14th day, overall oral hygiene was poor in group I and good in group II, significant statistically (p = 0.031). Iatrogenic injury to tooth was absent in group I and present in 1 case in group II, not significant statistically (p = 0.305). Average time taken for the IMF in group I was 74.9 minutes, with the range of 58 to 88 minutes, and in group II was 16.1 minutes, with the range of 11 to 22 minutes, which is highly significant statistically (p = 0.001). Needle stick injuries were taken as positive if glove perforation was present and these were reported in four cases in group I, whereas in group II, no case had incidence of needle stick injuries, which shows significant statistically (p = 0.025). Conclusion After this study, we can conclude that IMF selftapping screw is a proven useful technique of IMF. Intermaxillary fixation is a safe and less time-consuming method but with various shortcomings and complications, which the surgeon must be aware of while providing treatment. Clinical significance: How to cite this article Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y. Self-tapping Intermaxillary Fixation Screw: An Alternative to Arch Bar. J Contemp Dent Pract 2017;18(2):147-151.

Comparison of the Efficiency of Maxillomandibular Fixation Screws over Erich Arch Bars in achieving Intermaxillary Fixation in Maxillofacial Trauma: A Clinical Study

“…This was significantly more when compared with Nandini et al 9 (8.52 ± 2.7 minutes). Barodiya et al 10 and Qureshi et al 6 documented the time range similar to our study: 16.1 and 15.56 minutes respectively.…”

“…Rai et al 8 in a comparative study also reported more plaque accumulation in patients treated using Erich arch bars as compared with MMF screws. Similar results were documented by Qureshi et al, 6 Nandini et al, 9 and Barodiya et al 10 They found a significant difference between the plaque index values of both the groups and based on this, they concluded that maintenance of oral hygiene is better in patients treated using MMF screws.…”

“…Similar complications were noted by few researchers as well. 6,9,10 In this study, there were no occurrences of root damage associated with IMF screws. Hence, proper planning prior to the insertion of MMF screws is essential.…”

“…These results were in close association with results from various other studies. 6,9,10 There was no such occurrence with the use of MMF screws.…”

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

“…Some authors suggest that the use of IMF screws is less time consuming, provides better oral hygiene and reduces the risk of needle stick injury. 12,13 Conversely, use of IMF screws is associated with teeth root damage and screw loosening leading to instability of MMF. Despite these disadvantages, IMF screws are suggested as an alternative to arch bar for achieving IMF in the management of maxillofacial trauma.…”