ABSTRACT
Objective: To evaluate the clinical results of intermaxillary fixation screws used in the management of oral and maxillofacial bone fracture. Methods: The clinical and imaging data of 166 cases of oral and maxillofacial bone fractures treated by intermaxillary fixation screws were analyzed retrospectively with the implant location,numbers and the complications of the treatment. Results: 668 intermaxillary fixation screws were used in the 166 cases,at an average of 4 screws per case. The occlusal relationship of the patients was perfect after 1 week traction. Radiographs showed 105 screws (15. 7％) reached the superficial layer of dentin,middle or deep layer in 14 cases (2. 1％),and root canal injury in 2 cases(1. 2％). No intermaxillary fixation screw was broken,loosened or fallen off. Conclusion: Intermaxillary fixation screws can be effectively used in the management of oral and maxillofacial bone fracture. For the most cases,4-6 screws can meet the needs. Root injuries and other complications should be avoided.
ABSTRACT
PURPOSE: After exposure of fracture site, the proximal segment must be reduced to their preinjury position for open reduction of fractured mandibular condyle. We examined the use of inter-maxillary fixation screws or titanium screws tied with stainless steel wire to assist in positioning of proximal segment. Since it enables to make a relatively small preauricular incision by not disturbing the operative field like Moule pin, we can reduce the danger of injury to the facial nerve. METHODS: A preauricular approach was used for exposure, reduction, and rigid fixation in 4 cases of mandibular condylar fractures. Inter-maxillary fixation screws or titanium screws tied with stainless steel wire were used to assist in aligning proximal segment. The joints were submitted to functional exercises and postoperative radiologic and clinical follow-ups were performed. RESULTS: No facial nerve lesions were found in all 4 cases. Radiologic follow-up showed correct reduction and fixation in all 4 cases. Clinical follow-up showed an initial limitation, but normal morbility of the condyle was achieved within 4 months after the operation, with a maximum mouth opening of 34.1+/-5.2 mm after 12 months. There found no occlusal disturbances, no trismus, no lateral deviations of the mandible. CONCLUSION: By using Inter-maxillary fixation screws tied with stainless steel wire, it was shown that reducing the proximal segment to their preinjury position is easy to perform and it enables us to make a minimal dissection below preauricular skin incision to avoid facial nerve injury.