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Plast Reconstr Surg ; 137(1): 142e-150e, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26710045

RESUMO

BACKGROUND: The SMARTLock Hybrid MMF System from Stryker is a newer approach for maxillomandibular fixation. This study was performed to determine the clinical application, complications, radiographic findings, and cost effectiveness of the SMARTLock system. METHODS: A retrospective cohort study was performed with the SMARTLock system over 6 months. Demographics, history, fracture location, placement/removal time, and complications were obtained, along with cost analysis. RESULTS: The authors identified 35 patients with the SMARTLock system. Twenty-four patients remained after exclusion criteria. There were 19 male patients (79 percent) and five female patients (21 percent), with a mean age of 30.7 years. The mean application time of the SMARTLock system was 14.4 minutes, and the mean removal time was 10.5 minutes. Three hundred nineteen total screws were placed. The number and percentage of patients with complications associated with the SMARTLock system were as follows: mucosal overgrowth [n = 9 (38 percent)], screw loosening [n = 4 (17 percent)], lip irritation [n = 4 (17 percent)], malocclusion [n = 3 (13 percent)], nonunion [n = 1 (4 percent)], wound dehiscence [n = 1 (4 percent)], screw loss [n = 1 (4 percent)], tooth devitalization [n = 1 (4 percent)], loose plate [n = 1 (4 percent)], and plate fracture [n = 1 (4 percent)]. There were no instances of sharps exposure, tooth loss, or infection. One tooth required endodontic therapy. The number of screws that damaged teeth on cone-beam computed tomographic imaging was 24 (7.5 percent). The cost analysis showed similar cost between Erich arch bars and the SMARTLock system. CONCLUSIONS: This study suggests that the SMARTLock Hybrid MMF System is safe and easy to use, and with a cost similar to that of Erich arch bars. Appropriate treatment planning and previous surgical experience should be used to determine appropriate case selection, as this system is not ideal in all situations. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Placas Ósseas , Parafusos Ósseos , Tomografia Computadorizada de Feixe Cônico/métodos , Fixação Interna de Fraturas/métodos , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Fraturas Mandibulares/cirurgia , Complicações Pós-Operatórias , Adulto , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Fraturas Mandibulares/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
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