To compare the efficiency of maxillomandibular fixation screws over erich arch bar in achieving intermaxillary fixation in maxillofacial trauma: A clinical study

Study Design: Systematic review and meta-analysis. Objective: Maxillomandibular fixation (MMF) is a step of paramount importance during the management of maxillofacial trauma. Erich arch bars are being used for this purpose for decades but with advances in maxillofacial trauma management, intermaxillary fixation screws came into existence and are being used routinely. The present study was designed to identify if the intermaxillary fixation screws are really an alternative to Erich arch bars for management of maxillofacial trauma. Methodology: An exhaustive literature search was conducted in May 2020 on various electronic databases and studies comparing Erich arch bars and intermaxillary fixation screws were recruited for the analysis. Random-effects model with Mantel Haenszel statistics was used to analyze oral hygiene and duration of achieving MMF. Results: A total of 96 studies were identified, out of which 8 studies were included in the meta-analysis. There was no statistically significant difference in oral hygiene status of the patients in both the groups. Intermaxillary fixations screws required statistically significantly less time in achieving MMF. Needle stick injury was prominently seen with the use of Erich arch bar whereas other complications like mucosal coverage, root injury, screw loosening and screw fracture makes the use of intermaxillary fixation screws questionable. Conclusion: The present meta-analysis suggests that there is not enough evidence to recommend the use of intermaxillary fixation screws as an alternative to Erich arch bars. Further research with large sample size, high quality evidence and better methodology is recommended in this direction.

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The Use of Risdon Cables in Pediatric Maxillofacial Trauma: A Technique Revisited

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1313362 ◽

2012 ◽

Vol 5 (2) ◽

pp. 107-109 ◽

Cited By ~ 2

Author(s):

Matthew Madsen ◽

Paul S. Tiwana ◽

Brian Alpert

Keyword(s):

Primary Teeth ◽

Maxillofacial Trauma ◽

Facial Skeleton ◽

Intermaxillary Fixation ◽

Pediatric Fractures ◽

Arch Bar ◽

Tooth Buds ◽

Future Growth

Although less common than adult fractures, fractures of the pediatric maxillofacial skeleton present unique challenges. Different considerations including variations of anatomy including tooth buds, dental variations, as well as considerations for future growth must be addressed. When traditional techniques to treat adult fractures are applied for securing intermaxillary fixation (IMF) such as arch bars, difficulty arises because the primary teeth are shorter and conventional arch bar techniques may slip off intra or postoperatively. We present a technique to achieve both IMF as well as interdental stability using a Risdon cable. Although this technique is not new, we present it as our preferred method for treating pediatric fractures of the facial skeleton where IMF must be accomplished.

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Comparative Evaluation of the Embrasure Wire versus Arch Bar Maxillomandibular Fixation in the Management of Mandibular Fractures: Are Arch Bars Replaceable?

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1603453 ◽

2018 ◽

Vol 11 (2) ◽

pp. 118-123

Author(s):

Sanjay Rastogi ◽

Tousif Ahmed ◽

Kolli Giri ◽

Ramakant Dandriyal ◽

Indra B. Niranjana Prasad ◽

...

Keyword(s):

Statistical Significance ◽

Demographic Data ◽

Study Data ◽

Mandibular Fractures ◽

Intermaxillary Fixation ◽

Maxillomandibular Fixation ◽

Arch Bar ◽

Significant Difference ◽

Group A ◽

Group B

The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t-test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B ( p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B ( p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.

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A comparative randomized prospective clinical study on modified erich arch bar with conventional erich arch bar for maxillomandibular fixation

Annals of Maxillofacial Surgery ◽

10.4103/ams.ams_20_20 ◽

2020 ◽

Vol 10 (2) ◽

pp. 287

Author(s):

V Venugopalan ◽

G Satheesh ◽

A Balatandayoudham ◽

S Duraimurugan ◽

TS Balaji

Keyword(s):

Clinical Study ◽

Prospective Clinical Study ◽

Maxillomandibular Fixation ◽

Arch Bar

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MANDIBULAR FRACTURE MANAGEMENT;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3363 ◽

2019 ◽

Vol 26 (04) ◽

Cited By ~ 1

Author(s):

Manoj Kumar ◽

Syed Fida Hussain Shah ◽

Suneel Kumar Panjabi ◽

Soonhan Abdullah ◽

Salman Shams

Keyword(s):

Operative Time ◽

Mandibular Fracture ◽

P Value ◽

Mandibular Fractures ◽

Maxillomandibular Fixation ◽

Arch Bar ◽

Case Series Study ◽

Fracture Management ◽

Maxillomandibular Fixation Screws ◽

Screw Group

Objectives: To compare the efficacy of Maxillomandibular fixation screws versus Erich Arch bar in the management of mandibular fractures. Study Design: Comparative case series study. Setting: Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Liaquat University Hospital Hyderabad, Jamshoro. Period: 29/03/2016 to 28/09/2016. Methodology: Forty patients of either gender with age above 18 years with mandibular fracture requiring closed reduction were included. 20 patients of Groups A, treated with Maxillomandibular fixation screws and 20 patients of Group B treated with Erich Arch bar. Mean operative time was noted. All patients were followed up on every week up to four weeks. The statistical analysis via t-test was used and P-value <0.05 was categorized as significant. Results: In MMF screw group 13(65.0%) patients were male and 7(35.0%) patients were female whereas in Arch Bar group, 15(75.0%) were male and 5(25.0%) were female. Evidence of wire stick injury was found positive in 2(10.0%) and 4(20.0%) patients among MMF screw and Arch Bar groups respectively. In MMF screw group, mean operative time was 84.20±18.04 minutes whereas in Arch Bar groups it was 121.80±13.68 minutes. The mean operative time is significantly reduced in MMF screw group as compared to Arch Bar group with p value <0.01. Conclusion: We conclude that Maxillomandibular fixation with screws was more worthwhile mode as matched to the conservative Erich arch bars for managing the mandibular fractures.

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