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Published on: October 18, 2021
Intermaxillary screw fixation in mandibular fracture repair
Eric Bissada1, Zahi Abou-Chacra, Christian Ahmarani
1Department of Otolaryngology-Head and Neck Surgery, University of Montreal, 5415 boulevard de l'Assomption, Montreal, QC H1T 2M4. ericbissada@yahoo.com
Summary
Intermaxillary fixation (IMF) screws provide a reliable alternative for mandibular fracture repair, achieving normal occlusion in 97.2% of patients. Careful planning is essential for successful outcomes with this technique.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Trauma Surgery
Background:
- Restoring premorbid occlusion is critical for successful mandibular fracture reduction.
- Intermaxillary fixation (IMF) is a cornerstone of accurate mandibular fracture repair.
- Arch bars are the current standard for IMF, but IMF screws offer potential benefits.
Purpose of the Study:
- To evaluate the effectiveness of IMF screws in managing mandibular fractures.
- To describe the technique for using IMF screws.
- To identify patient groups who would benefit from IMF screws without compromising outcomes.
Main Methods:
- Prospective study of 36 patients with displaced mandibular fractures treated with screw IMF.
- Open reduction internal fixation performed conventionally after screw IMF.
- Postoperative plain films and regular follow-up evaluations for fracture reduction and screw placement.
Main Results:
- 97.2% of patients (35/36) achieved normal occlusion at 6 weeks postoperatively.
- One case of root fracture and four cases of root impingement by screws were identified.
- Screw IMF demonstrated effectiveness in achieving desired occlusion.
Conclusions:
- Cortical bone screws are a reliable alternative to traditional IMF methods for mandibular fractures.
- IMF screws offer advantages for surgeons and patients but require awareness of potential complications.
- Thorough preoperative planning is crucial for maximizing successful results with IMF screws.
