Self Tapping Screws v/s Erich Arch Bar for Inter Maxillary Fixation: A Comparative Clinical Study in the Treatment of Mandibular Fractures

Introduction and Objective  

Numerous methods have been described for achievement of Intermaxillary fixation in the treatment of fractures of facial skeleton. Conventional methods like Erich arch bars and eyelet wires are currently most common methods for achieving intermaxillary fixation (IMF), but they have their own disadvantages. Since 1989, IMF using intraoral self tapping IMF screws has been introduced for treatment of mandibular fractures. The aim of this work was to compare the efficacy, advantages, disadvantages indications and potential complications associated with Erich archbar v/s self tapping IMF screws in the management of mandibular fractures.     

Comparative Evaluation of the Resin Bonded Arch Bar Versus Conventional Erich Arch Bar For Intermaxillary Fixation

Purpose  

Application of Erich arch bar with the help of circumdental wires for intermaxillary fixation is most widely accepted method for mandibular fractures. However, circumdental wires causes injury to periodontium. There is always fear of inadvertent injury by wire ends and chances of serotransmission of blood born viruses to the operator thus, we want to use the safest method of intermaxillary fixation avoiding use of circumdental wires.     

Esthetic Arch Bar for Maxillomandibular Fixation in Orthognathic Surgery

Arch bars are well-known dental appliances for the management of fractures and orthognathic surgery. Traditionally both the commercially available, prefabricated arch bars as well as the custom-made arch bars are made of metal so as to provide good rigidity. Each of these types of arch bars has its own advantages as well as drawbacks. This article looks at a type of custom-made arch bar that is easy to construct and use. At the same time, it provides good rigidity, fit, and esthetics.     

下颌骨骨折生物接骨内固定的三维有限元分析

目的:用计算机对生物可吸收板在下颌骨骨折内固定中进行三维有限元的分析,来估计生物可吸收板在典型的角部和体部骨折时能否提供所需的强度和力度。方法:在ANSYS6.0软件中建立下颌骨角部和体部骨折的内固定三维有限元模型,施加载荷后,分别计算角部、体部骨折钛板单、双板及生物可吸收板单、双板固定时,骨折段位移、骨断层的应力,固定板的应力。结果:角部和体部骨折钛板单、双板固定,生物可吸收板双板固定时骨折段位移、骨断层的应力,固定板的应力均在安全范围内;角部骨折生物可吸收板单板固定时骨折段位移超出安全范围;体部骨折生物可吸收板单板固定时固定板的应力超出安全范围。结论:生物可吸收板双板固定在下颌骨角部和体部骨折早期时可以提供骨折愈合的条件。     

Transoral 2.0-mm Locking Miniplate Fixation of Mandibular Fractures Plus 1 Week of Maxillomandibular Fixation: A Prospective Study

PURPOSE: In this study, a 2.0-mm locking miniplate (LMP)/screw system was assessed in the treatment of mandibular fractures with a 1-week period of maxillomandibular fixation (MMF). PATIENTS AND METHODS: Fifty mandibular fractures in 34 patients with a mean of 6.97 days of MMF were included in the study. The 2.0-mm LMPs were adapted along Champy's line of ideal osteosynthesis and secured with four 8.0-mm locking monocortical screws. All patients were followed for a minimum of 6 weeks. The incidence of soft tissue infections, nonunion, malunion, malocclusion, osteomyelitis, nerve injury, and tooth damage was prospectively assessed. RESULTS: Primary bone healing was achieved in 98% of cases. Three complications (6%) were observed. Two minor complications of intraoral wound dehiscence and malocclusion were noted. A fibrous nonunion requiring 3 additional weeks of MMF was noted. No evidence of malunion, osteomyelitis, plate fracture, iatrogenic nerve injuries, or dental injuries was noted. CONCLUSIONS: A single 2.0-mm LMP placed along Champy's line of ideal osteosynthesis with four 8-mm monocortical locking screws plus 1 week of MMF fixation is a reliable and effective treatment modality for mandibular fractures.     

下颌前部骨折拉力螺钉与小型接骨板固定的疗效比较

目的 比较下颌前部骨折应用拉力螺钉固定和小型接骨板固定的疗效。方法 下颌前部单线骨折14例，应用1枚拉力螺钉固定，8例应用2块小型接骨板固定，术后2～3周、3～4个月复诊。比较两组术后He关系、He力及颏神经损伤等情况。结果 2组患者在上述指标的比较中无显著性差异，但拉力螺钉固定组，平均手术时间较小型接骨板固定组显著缩短。结论 下颌前部骨折用1枚拉力螺钉固定，即可达到与2块小型接骨板固定相近的临床效果;其手术操作简单,时间短,费用低,并可在骨折线上产生压应力．促进骨折俞合。     

Resorbable Plates for Fixation of Complicated Mandibular Fractures in Children

Purpose

The purpose of this article was to review our experience in the treatment of complicated mandibular fractures in children using resorbable plates.

Patients and Methods

Records of 14 patients who sustained and presented to our department with complicated fractures of the mandible, and were treated with resorbable plates were retrieved. Permission was sought from and granted by the institution ethical committee. Data extracted included patients’ gender, age, etiology of fracture, nature of fracture and site of the fracture.

Results

Of the 14 patients, there were 10 males and 4 females with a male to female (M:F) ratio of 2.5:1. Their ages ranged from 6 to 15 years, with a mean of 10.14 years. The etiology of the fractures included road traffic accidents (n = 11) and falls (n = 3). Most of the fractures were sustained on the body of the mandible. Majority of the patients had displacement of the fracture segments; 2 patients had comminuted fractures. All the fractures were treated using resorbable plates and healed uneventfully.

Conclusion

Whereas the number of patients in this case series was small, it is worth noting that children sometimes present with complicated fractures of the mandible, thereby necessitating open reduction and internal fixation. Resorbable plates when available and affordable, are an effective option for open reduction and internal fixation of such fractures.