ABSTRACT
AIM: Comparative evaluation of efficacy of conventional arch bar, intermaxillary fixation screws, and modified arch bar with respect to plaque accumulation, time required for procedure, postoperative stability after achieving the intermaxillary fixation, mucosal growth, and complication encountered for intermaxillary fixation. MATERIALS AND METHODS: This study is a randomized clinical trial in which participants were divided into three groups of 10 each, and designated as Group A, Group B, and Group C. In Group A, intermaxillary fixation was achieved by the conventional method using Erich arch bar, fastened with 26-gauge stainless-steel wires. In Group B, intermaxillary fixation was achieved by the use of 2 mm × 8 mm 4-6 stainless-steel intermaxillary fixation screws. In Group C, intermaxillary fixation was achieved by modified screw arch bar. A conventional arch bar was modified by making perforations in the spaces between the winglets along the entire extension of the bar which was then adapted to the vestibular surface of the maxilla and mandible, close to the cervical portion of the teeth, and perforations were made in the inter-radicular spaces with a 1.1-mm bur, and after this, 1.5-mm screws were placed to fix the bar. RESULTS: In the present study, a total of 30 patients were analyzed. The average working time for Group A, Group B, and Group C were 110, 16, and 29 min respectively. Oral hygiene scores through modified Turskey Gilmore plaque index which was taken at immediate postoperative, 15, 30, and at 45 days. Maximum hygiene was maintained in intermaxillary fixation screw group followed by modified arch bar group and conventional arch bar group. Maximum stability was seen in the conventional arch bar group followed by modified arch bar group and intermaxillary fixation screw group. With respect to mucosal coverage, maximum mucosal growth was seen in intermaxillary fixation screws group. When complications were taken into consideration, maximum complications were reported in Group A followed by Group B and Group C. CONCLUSION: This study emphasizes that the use of modified arch bar is quick and easy method than conventional arch bar with least chances of glove puncture and needle stick injury to the operator. Oral hygiene maintenance is comparatively better in patients with modified arch bar than with conventional arch bars. Modified arch bar was significantly stable when compared with IMF screws, and therefore, for the patients who require long-term intermaxillary fixation, modified arch bars can be a viable option.
ABSTRACT
AIM: This study aimed to evaluate the efficacy of intermaxillary fixation (IMF) screws and modified arch bar. MATERIALS AND METHODS: This study is a randomized clinical trial in which all participants were divided into two groups of ten in each group and designated as Group A and Group B. In Group A, IMF was achieved by the use of four to six 2×8mm stainless steel IMF screws. In Group B, IMF was achieved by modified screw arch bar. RESULTS: In the present study, a total of twenty patients were analyzed. The average working time for Group A and Group B was 16 min and 29 min, respectively. Oral hygiene scores through modified Turesky Gilmore plaque index were calculated at immediate postoperative period and after 15 days, 30 days, and 45 days. Maximum hygiene was maintained in IMF screw group than modified arch bar group, but maximum stability was observed in the modified arch bar group than IMF screw group. CONCLUSION: This study emphasizes the use of IMF screws as a quick and easy method than modified arch bar. Oral hygiene maintenance was comparatively better in patients with IMF screws than those with modified arch bar. Modified arch bar was significantly stable when compared with IMF screws; therefore, for patients who require long-term IMF, modified arch bars can be a viable option, but the perforation in the original arch bar may lead to the weakening of the arch bar, and therefore the prefabricated modified arch bar would be a better option.
ABSTRACT
BACKGROUND: Bifid mandibular canal (BMC) is a normal anatomical variation and has been less studied in the Indian population. This study was aimed at estimating the prevalence of BMC amongst Indian population. MATERIALS AND METHODS: The study sample comprised of 5800 digital orthopantomograms (OPGs) which were from four zones of India, i.e. North India, South India, East India, and West India (1700 OPGs from each zone). Any pathological or normal digital OPGs having age between 15 and 80 years in the format of jepg or jpg image were included, while OPGs of operated case of hemimandibulectomy and blurred in which mandibular canal was not traceable were excluded from this study. Each radiograph was assessed for BMC based on the classification given by RP Langlais. Four examiners (two Oral and Maxillofacial surgeons and two Oral and Maxillofacial Radiologists) individually assessed every OPG for the presence of BMC. BMC was considered present, if all the examiners detected it independently. RESULTS: There were 5800 OPGs examined, out of which 2576 were of women and 3224 were of men. Bifid mandibular canals were observed in 135 (2.3%) out of 5800 digital panoramic images. There was no statistically significant correlation found with regard to age. Bifid mandibular canals were found with a female-to-male ratio of 1:1.2. The most frequently encountered type of BMC was type II (1.34%) followed by type I (0.72%), type IV (0.15%), and type III (0.1%).