MAXILLOMANDIBULAR FIXATION USING ORTHODONTIC MINI-IMPLANTS IN MANAGEMENT OF MANDIBULAR FRACTURES

Document Type : Original Article

Authors

1 Assist. Prof. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Beirut Arab University, Lebanon and Lecturer of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt.

2 Professor of Oral & Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt

Abstract

INTRODUCTION: The use of intermaxillary fixation (IMF) in the treatment of maxillofacial trauma represents the cornerstone of fracture reduction and immobilization. Many modalities of IMF have been described. Recently, to overcome the cumbersome procedure of tooth borne appliances, miniimplants have been introduced into clinical practice. OBJECTIVES: To evaluate the effectiveness of using mini-implants for IMF for the treatment of mandibular fractures. MATERIALS AND METHODS: This clinical trial was performed on ten patients with mandibular fractures. The diagnosis, duration of IMF, miniimplants site, bite force recovery, bone density around the fracture line and any associated complications were recorded. Clinical and radiographic follow-up examinations were performed immediately, 3 and 6 months post-operatively until fracture healing was complete. CONCLUSIONS: The use of mini-implants for IMF has shown to be a useful and safe modality to establish maxillo-mandibular fixation following mandibular fractures.

Keywords

Main Subjects

References

1. Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg 2003; 61: 713-8. 
2. Thaller SR. Management of mandibular fractures. Arch Otolaryngol Head Neck Surg 1994; 120: 44-7. 
3. Sinbel A, Shaaban A, Shokry M. The efficacy of arthrocentesis on restoring mandibular function in unilateral subcondylar fracture following maxillomandibular fixation (A clinicradiographic study). Alexandria Dental Journal, 2015; 40:51-7 . 
4. Coletti DP, Salama A, Caccamese JF Jr.: Application of intermaxillary fixation screws in maxillofacial trauma. J Oral Maxillofac Surg. 2007; 65(9):1746-50. 
5. Schneider AM, David LR, DeFranzo AJ, Marks MW, Molnar JA, Argenta LC.: Use of specialized bone screws for intermaxillary fixation. Ann Plast Surg. 2000; 44(2):154-7. 
6. Nandini GD, Balakrishna R, Rao J.: Self Tapping Screws v/s Erich Arch Bar for Inter Maxillary Fixation: A Comparative Clinical Study in the Treatment of mandibular fractures. J Maxillofac Oral Surg. 2011;10(2):127-31. 
7. Berens A, Wiechmann D, Dempf R. Mini- and micro-screws for temporary skeletal anchorage in orthodontic therapy. J Orofac Orthop. 2006; 67:450-8. 
8. Sherwood K. Correction of skeletal open bite with implant anchored moral/bicuspid intrusion. Oral Maxillofac Surg Clin North Am. 2007; 19:339-50. 
9. Schnelle M A, Beck F M, Jaynes R M, Huja S S. A radiographic evaluation of the availability of bone for placement of miniscrews. Angle Orthod. 2004; 74:832-7. 
10. Kyung H M, Park H S, Bae S M, Sung J H, Kim I B. Development of orthodontic micro-implants for intraoral anchorage. J Clin Orthod. 2003; 37:321-8. 
11.Reynders R, Ronchi L, Bipat S. Mini-implants in orthodontics: a systematic review of the literature. Am J Orthod Dentofacial Orthop. 2009 ; 135(5): 564.e1-19; discussion 564-5. 
12. Maino B G, Bednar J, Pagin P, Mura P. The spider screw for skeletal anchorage. J Clin Orthod. 2003; 37:90-7. 
13.Coburn DG., Kennedy DWG., Hodder SC. Complications with intermaxillary fixation screws in the management of fractured mandibles. Br J Oral Maxillofac Surg. 2002; 40: 241-3. 
14.Jones DC. The intermaxillary screws: a dedicated bicortical bone screw for temporary intermaxillary fixation. Br J Oral Maxillofac Surg. 1999; 37: 115-6. 
15.Costa A, Raffaini M, Melsen B. Miniscrews as orthodontic anchorage: a preliminary report. Int J Adult Orthodn Orthognath Surg. 1998; 13: 201-9. 
16. Ueki K, Marukawa K, Shimada M, Nakagawa K, Yamamoto E. The use of an intermaxillary fixation screw for mandibular setback surgery. J Oral Maxillofac Surg. 2007 ; 65(8):1562-8. 
17.Roccia F., Tavolaccini A., Dell’acqua A., Fasolis M. An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screws. J Cranio-maxillofac Surg. 2005; 33: 251-4. 
18. Poggio PM, Incorvati C, Velo S, Carano A. "Safe zones": a guide for miniscrew positioning in the maxillary and mandibular arch. Angle Orthod. 2006 ; 76(2):191-7. 
19. Hernández LC, Montoto G, Puente Rodríguez M, Galbán L, Martínez V. 'Bone map' for a safe placement of miniscrews generated by computed tomography. Clin Oral Implants Res. 2008 ; 19(6):576-81. 
20. Asscherickx K, Vannet BV, Wehrbein H, Sabzevar MM. Root repair after injury mini-screw. Clin Oral Impl Res. 2005; 16: 575-8. 
21. Gupta A, Singh V, Mohammad S. Bite force evaluation of mandibular fractures treated with microplates and miniplates. J Oral Maxillofac Surg. 2012;70:1903-8 
22. Dean JS, Throckmorton GS, Ellis E 3rd, Sinn DP. A preliminary study of maximum voluntary bite force and jaw muscle efficiency in pre-orthognathic surgery patients. J Oral Maxillofac Surg. 1992;50:1284-8. 
23. Kshirsagar R, Jaggi N, Halli R. Bite force measurement in mandibular parasymphyseal fractures: A preliminary clinical study. Craniomaxillofac Trauma Reconstr. 2011;4:241-4. 
24. Koc D, Dogan A, Bek B. Bite force and influential factors on bite force measurements: A literature review. Eur J Dent. 2010;4:223–32. 
25. Koç D, Dogan A, Bek B. Effect of gender, facial dimensions, body mass index and type of functional occlusion on bite force. J Appl Oral Sci. 2011;19:274-9. 
26. Pepato AO, Palinkas M, Regalo SC, de Medeiros EH, de Vasconcelos PB, Sverzut CE, et al. Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility. J Craniofac Surg 2014; 25: 1714-20. 
27. Melek LN, Evaluation of the 3-Dimensional Threadlock plate in the management of mandibular angle fractures. Ph.D. Thesis. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University. 2014. 

Files

Share

How to cite

Statistics