Pankaj Pathak1, Shaji Thomas1, Darpan Bhargava2, Sivakumar Beena1. 1. Oral and Maxillofacial Surgery, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhanpur, Bhopal, 462 037, Madhya Pradesh, India. 2. Oral and Maxillofacial Surgeon, Private Practice, H-3/2, BDA Colony, Nayapura, Lalghati, Airport Road, Bhopal, 462 001, Madhya Pradesh, India. drdarpanbhargava@gmail.com.
Abstract
INTRODUCTION: Intermaxillary fixation (IMF) is commonly performed in the management of facial skeleton fractures. Various conventional methods like Erich's arch bar and Ivy eyelet wiring are the most commonly employed methods for achieving IMF, but they have their own disadvantages. Conventional Erich's arch bar (CEAB) has been modified recently by making perforations in the spaces between the winglets and securing the arch bar using 1 mm screws. IMF using intraoral modified screw retained arch bar (SRAB) has been introduced for the treatment of mandibular fractures. The aim of this study was to compare the efficacy, advantages, disadvantages, indications, and potential complications associated with CEAB versus modified SRAB in the management of mandibular fractures. MATERIALS AND METHODS: A randomized prospective study included 20 patients with mandibular fracture who were randomly allotted to two groups. Group A patients received modified SRAB and group B patients received CEAB. The parameters considered were time taken to place the arch bar, perforation in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle (wire) stick injuries during IMF. RESULTS: The mean time taken for arch bar placement was 27.20 min with modified SRAB as compared with 82.50 min with CEAB. Incidence of glove perforations was more in group B patients. Oral hygiene status was good in 90% of the patients from group A whereas it was 100% fair in group B patients. CONCLUSION: This study has shown that both the techniques achieve satisfactory IMF with post-operative occlusion. IMF with modified SRAB reduces the operating time and the incidence of the needle (wire) prick injuries. But modified SRAB has its own limitations in spite of its ease of application.
INTRODUCTION: Intermaxillary fixation (IMF) is commonly performed in the management of facial skeleton fractures. Various conventional methods like Erich's arch bar and Ivy eyelet wiring are the most commonly employed methods for achieving IMF, but they have their own disadvantages. Conventional Erich's arch bar (CEAB) has been modified recently by making perforations in the spaces between the winglets and securing the arch bar using 1 mm screws. IMF using intraoral modified screw retained arch bar (SRAB) has been introduced for the treatment of mandibular fractures. The aim of this study was to compare the efficacy, advantages, disadvantages, indications, and potential complications associated with CEAB versus modified SRAB in the management of mandibular fractures. MATERIALS AND METHODS: A randomized prospective study included 20 patients with mandibular fracture who were randomly allotted to two groups. Group A patients received modified SRAB and group B patients received CEAB. The parameters considered were time taken to place the arch bar, perforation in the gloves, patient acceptance, oral hygiene, iatrogenic dental injuries, and needle (wire) stick injuries during IMF. RESULTS: The mean time taken for arch bar placement was 27.20 min with modified SRAB as compared with 82.50 min with CEAB. Incidence of glove perforations was more in group B patients. Oral hygiene status was good in 90% of the patients from group A whereas it was 100% fair in group B patients. CONCLUSION: This study has shown that both the techniques achieve satisfactory IMF with post-operative occlusion. IMF with modified SRAB reduces the operating time and the incidence of the needle (wire) prick injuries. But modified SRAB has its own limitations in spite of its ease of application.
Authors: Ahtesham Ahmad Qureshi; Umesh K Reddy; N M Warad; Sheeraz Badal; Amjad Ali Jamadar; Nilofar Qurishi Journal: Ann Maxillofac Surg Date: 2016 Jan-Jun