Are embrasure wires better than arch bars for intermaxillary fixation?

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Medical Device Technology

Background:

• Mandible fractures are common injuries requiring surgical intervention.
• Open reduction and internal fixation (ORIF) is a standard treatment.
• Adjunctive intermaxillary fixation (IMF) is often used to stabilize the bite during healing.

Purpose of the Study:

• To compare clinical outcomes and costs of mandible fractures treated with ORIF and adjunctive IMF using either embrasure wires or arch bars.

Main Methods:

• Retrospective review of 86 patients with mandible fractures treated with ORIF and IMF.
• Data collected included demographics, fracture details, complications (infection, malunion, nonunion, hardware failure, dehiscence), and costs.
• Statistical analysis using Student's t test and chi-square/Fisher's exact test (P < .05).

Main Results:

• The embrasure wire group (33 patients) had a 15% complication rate versus 26% in the arch bar group (53 patients).
• No statistically significant differences were found in infection, hardware failure, malocclusion, or nonunion between the groups.
• Arch bar placement and removal incurred an approximate cost of $2,672 more than embrasure wires.

Conclusions:

• Embrasure wire IMF demonstrated slightly superior clinical outcomes compared to arch bar IMF for mandible fractures.
• The use of embrasure wires resulted in significant cost savings.