Open reduction and internal fixation: Screw injury - Retrospective study

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Trauma Surgery

Background:

• Open reduction and internal fixation (ORIF) is a common surgical procedure for jaw trauma and orthognathic surgery.
• Screw insertion during ORIF poses a risk of accidental tooth root injury.
• Existing literature presents conflicting evidence on the incidence and outcomes of tooth damage during ORIF.

Purpose of the Study:

• To investigate the occurrence of tooth damage during ORIF procedures.
• To compare the incidence of tooth damage between ORIF for trauma and planned osteotomies.
• To address inconsistencies in current literature regarding ORIF-related tooth root injuries.

Main Methods:

• A retrospective study analyzing data from patients who underwent ORIF for either trauma or orthognathic surgery.
• Inclusion and exclusion criteria were applied to select relevant patient data.
• Analysis of screw placement and potential tooth root involvement in 1632 patients.

Main Results:

• Out of 9073 screws analyzed, 93.40% had no tooth contact, 6.3% had potential contact, and 0.28% showed evidence of root damage.
• Molar and premolar teeth showed a statistically significant difference in screw contact based on surgery type (P ≤ 0.05).
• Canine and incisor teeth did not show a statistically significant difference in screw contact (P = 0.75 and P = 0.67, respectively).

Conclusions:

• ORIF is a safe and effective method for managing jaw fractures when performed with meticulous technique.
• Tooth root injury during ORIF is a known complication but is preventable with careful surgical planning and execution.
• The study highlights the importance of precise screw placement to avoid dental complications in ORIF procedures.