Abstract
Introduction: Occlusion is the way in which one’s maxillary and mandibular teeth relate to each other when the jaw is closed. When treating fractures of the mandible, the first and primary objective is to re-establish the patient’s premorbid occlusion which is required for the mastication and also the other objective is to achieve esthetics. Inter-maxillary fixation (IMF) plays a vital role in management of fractures involving maxilla and mandible & helps in stabilizing the patient’s occlusion and thus reduction in fracture segments. Many modalities for obtaining intermaxillary fixation like Arch bars, eyelets, interdental wiring, orthodontic braces and intermaxillary fixation screws have been considered. Every method used for intermaxillary fixation has its own merits and demerits.
Materials and Method: A prospective randomized clinical study was conducted between 2015 to 2017 in Patients who reported with mandibular fractures to the department of Oral & Maxillofacial Surgery at Vydehi Institute of Dental Sciences and Research Centre. A total of 50 patients with mandibular fractures requiring internal fixation were divided into two groups. Group A consisted of patients in whom Erich’s arch bars were placed for IMF and Group B consisted of patients in whom IMFS were placed for IMF. Patients included were those who required IMF, Subjects in good health i.e; ASA I,II and III. Patients excluded were completely edentulous, ASA IV subjects, Comminuted fractures, Pediatric patients, Panfacial fractures.
Results: Use of arch bars as seen in our results has a few disadvantages over IMF screws like time consumed in application and removal is more, Increased pain scores, Increased number of needle stick injuries and difficulty in maintaining oral hygiene, however it has its own advantages like it can be used in the treatment of dentoalveolar fractures, multiple teeth bearing fractured fragments can be reduced into an arch form.
Use of IMF screws provide better oral hygiene status as well as same occlusal results as of arch bars. Decreased number of needle stick injuries and takes lesser time to apply and remove. IMF screws are useful in mandibular fractures which are not grossly displaced or comminuted.
Conclusion: Use of both the techniques in achieving IMF is efficacious with both the techniques having merits and demerits over each other. Although both the techniques offer good temporary intermaxillary fixation, the benefits and risks of both the techniques should be weighed depending on the type of fracture we are dealing with.
Keywords: IMF