title: The fate of teeth transfixed by osteosynthesis screws.
abstract: Rigid internal fixation with plates and screws for osteosynthesis of facial fractures and osteotomies in the cranio-maxillofacial skeleton is often undertaken in situations in which the exact position of the underlying tooth roots cannot be determined. Therefore, a screw may be inadvertently placed into a root. There is scant data in the literature addressing the consequences of tooth impingement. This 5-year retrospective study documents the long-term outcome of teeth transfixed by osteosynthesis screws in a series of 387 consecutive facial fractures at a Level I trauma center. The incidence of root impingement per screw was 0.47 percent (13 transfixed teeth per 2340+ screws). Mandibular teeth were more "at risk" than maxillary teeth by a ratio of 10:3. No transfixed teeth became infected or required extraction in this series. In conclusion, inadvertent tooth root impingement by osteosynthesis screws appears to have minimal adverse consequences.
authors.affiliation: Division of Plastic Surgery, UMDNJ-Robert Wood Johnson Medical School, USA.
authors.forename: G L
authors.initials: GL
authors.lastname: Borah
authors.forename: D
authors.initials: D
authors.lastname: Ashmead
mesh_terms: D000328:Adult; D001863:Bone Screws; D005147:Facial Bones / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000601:surgery*; D014022:Tissue Survival; D014070:Tooth / Q000502:physiology*; D016896:Treatment Outcome