CONSIDERATIONS OF INTERMAXILLARY FIXATION METHODS IN THE MANAGEMENT OF MANDIBULAR FRACTURES

하악골 골절의 치료에 있어 악간 고정법에 관한 고찰

  • Song, Kyung-Ho (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Lee, Seul-Ki (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Chung, Jae-An (Department of Oral and Maxillofacial Surgery, Kang-nam Sacred Heart Hospital) ;
  • Shin, Jin-Eob (Department of Oral and Maxillofacial Surgery, Kang-nam Sacred Heart Hospital) ;
  • Kim, Jwa-Young (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Song, Sang-Hoon (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Yang, Byoung-Eun (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University) ;
  • Choi, Young-Jun (Department of Oral and Maxillofacial Surgery, College of Medicine, Chungang University) ;
  • Kim, Seong-Gon (Department of Oral and Maxillofacial Surgery, College of Medicine, Hallym University)
  • 송경호 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 이슬기 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 정재안 (강남성심병원 구강악안면외과학교실) ;
  • 신진업 (강남성심병원 구강악안면외과학교실) ;
  • 김좌영 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 송상훈 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 양병은 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 최영준 (중앙대학교 의과대학 구강악안면외과학교실) ;
  • 김성곤 (한림대학교 의과대학 구강악안면외과학교실)
  • Published : 2007.11.30

Abstract

Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

Keywords

References

  1. Byun BR, Cho YS, Lee JK et al : A study on the intermaxillary fixation by SAS in cases of simple fracture of mandible. J Korean Assoc Hosp Dent 2 : 102, 2006
  2. Roccia F, Tavolaccini A, Fasolis M et al : An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screw. J Cranio Maxillofac Surg 33 : 251, 2005 https://doi.org/10.1016/j.jcms.2005.02.005
  3. Holmes S, Hutchison I : Caution in use of bicortical intermaxillary fixation screw. Br J Oral Maxillofac Surg 38 : 574, 2000 https://doi.org/10.1054/bjom.2000.0514
  4. Jones DC : The intermaxillary screw. a delicated bicortical bone screw for temporary intermaxillary fixation. Br J Oral Maxillofac Surg 37 : 115, 1996
  5. Ayoub AF, Rowson J : Comparative assessment of two methods used for interdental immobilization. J Cranio Maxillofac Surg 31 : 159. 2003 https://doi.org/10.1016/S1010-5182(03)00022-2
  6. Vartanian AJ, Alvi A : Bone-screw mandible fixation: An intraoperative alternative to arch bar. Otolaryngol Head Neck Surg 123 : 718, 2000 https://doi.org/10.1067/mhn.2000.111286
  7. Govoni FA, Pistilli R, Piccolino P et al : Maxillo-mandibular fixation by mono-cortical screws. Clinical indications and surgical methods Minerva Stomatol 48 : 93, 1999
  8. Imazawa T, Komuro Y, Inoue M et al : Mandibular fractures treated with maxillo-mandibular fixation screws (MMFS method). J Cranifac Surg 17 : 544, 2006 https://doi.org/10.1097/00001665-200605000-00026
  9. Kim JH, Joo JY, Park YW et al : Study of maxillary cortical bone thickness for skeletal anchorage system in Korean. J Korean Oral Maxillofac Surg 28 : 249, 2002
  10. Coburn DG, Kennedy DWG, Hodder SC : Complications with intermaxillary fixation screws in the management of fractured mandibles. Br J Oral Maxillofac Surg 40 : 241, 2002 https://doi.org/10.1054/bjom.2001.0771
  11. Gibbones AJ. Hodder SC : A self-drilling intermaxillary fixation screw Br J Oral Maxillofac Surg 41 : 48, 2003 https://doi.org/10.1016/S0266-4356(02)00277-2
  12. Fordyce AM, Lalani Z, Songra AK et al : Intermaxillary fixation is not usually necessary to reduce mandibular fractures Br J Oral Maxillofac Surg 37 : 52, 1999 https://doi.org/10.1054/bjom.1998.0372