Evaluation of efficacy of intermaxillary fixation screws in maxillofacial trauma: A clinical study

Abstract

Background: Maxillomandibular Fixation (MMF) is a basic and fundamental principle in the management and treatment of the maxillofacial trauma patient. Stable IMF can be achieved by various techniques, the standard being the use of arch bars applied to both the dental arches and others like eyelets, bonded brackets, cast metal splints, pearl steel wires, self tapping IMF screws and self drilling IMF screws. Aims and Objective: The aim of the study is to Evaluate the Efficacy of Intermaxillary Fixation Screws as means of achieving intermaxillary fixation and to highlight the advantages and disadvantages of using IMF screws. Materials and Methods: 25 trauma patients were selected, based on thorough clinical examination and radiological examination requiring intraoperative maxillomandibular fixation to fix fractures. A stainless steel Intermaxillary fixation Screw of 8 mm length and 2 mm width were selected based on the type and severity of maxillofacial trauma. Regular clinical follow up was done after screw placement for evaluation of pulp vitality, loss of screws, loose screws/loose wires, breakage of screws or screws covered by oral mucosa and post-operative occlusion, pain, oral hygiene and in addition, any discomfort. Results: Among the 25 patients, 15 patients (60%) underwent closed reduction, five patients (20%) underwent ORIF with no MMF postoperatively and five patients (60%) underwent ORIF with IMF postoperatively. Percentage of pulp vitality, loss of screws, loose screws/loose wires, breakage of screws or screws covered by oral mucosa and post-operative occlusion, pain, oral hygiene were recorded. Students t test was performed to compare pre and post operative mouth opening. Conclusion: IMF screws present a more viable alternative to arch bars, as they are very easy to handle and it is a speedy way to achieve a reliable temporary preoperative, perioperative and post operative MMF in an economic manner. They are also considered as an ideal treatment modality for chronic generalized periodontitis cases who have met with trauma.