Use of Arch Bars versus IMF-Screws in Maxillomandibular Fixation of Mandibular Fractures: A Randomized Prospective Study with Special Evaluation of Sonographic Findings and Quality of Life

Abstract

Purpose Traditionally, arch bars are used for mandibulomaxillary fixation (MMF) of mandibular fractures. The introduction of intermaxillary fixation screws (IMFS) has provided an alternative for this purpose. We compared the arch bar versus IMFS for treatment of mandibular fractures including evaluation of sonographic findings and Quality of Life (QoL). Methods Fifty patients with mandibular fracture were recruited and randomly divided into 2 groups, 25 each in arch bars and IMFS. The parameters evaluated were; mouth opening, malocclusion, pain, fracture healing using ultrasound scanner, operating time, wire prick injuries, oral hygiene and QoL. Results There was a significantly higher pain score by 3rd and 6th postoperative week (p = 0.015 and p = 0.003 respectively) and shorter operating time (p < 0.001) in the IMFS group, while a notable higher wire-prick injuries (p < 0.001) and poor oral hygiene (p = 0.25) in the arch bar group. Ultrasound Scan at 6 postoperative weeks showed complete hyperechoic bridging callus in (61.5%) arch bar group and (50%) in IMF screw group, no significant difference statistically. Regarding QoL, patients treated with arch bars had more difficulty in continuing with their normal diet and indicated “they will not undergo the same treatment again”. On the other hand IMFS patients had significantly isolated themselves because of feeling of bad mood, and their sleep and speak was significantly affected. Conclusions Although some similarities were observed in both groups, this study suggests that IMFS addressed some of the limitations associated with arch bars. It’s safer and can be used for long time MMF. Trial registration number: PACTR202408851121914