Bone-screw mandible fixation: an intraoperative alternative to arch bars.
OBJECTIVE
Bone-screw mandible fixation (BSMF) is evaluated as an alternative to intraoperative arch-bar maxillomandibular fixation before plating of mandibular fractures. BSMF is achieved by wire ligation of opposing bone-screws placed in the maxilla and mandible.


METHODS
A retrospective evaluation of 23 patients with 40 mandibular fractures who underwent mandibular fracture repairs. BSMF was used instead of arch bars to ensure proper dental occlusion. All fractures were then plated, after which BSMF was removed before termination of anesthesia.


RESULTS
Normal occlusion was observed in 21 patients (91.3%), Class II malocclusion was noted in 1 patient (4. 3%), and 1 patient was edentulous. No complications related to the use of BSMF were observed.


CONCLUSIONS
BSMF can serve as a viable alternative to arch-bar maxillomandibular fixation for obtaining temporary intraoperative occlusion. BSMF produces acceptable malocclusion rates and offers the advantages of decreased intraoperative time, lower risk for percutaneous and mucosal wire punctures, and ease of use.
Vartanian
A J
AJ
Department of Otolaryngology-Head and Neck Surgery, Eye and Ear Infirmary, University of Illinois at Chicago, 60612-7244, USA. ajvartainian@prodigy.net
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D000062:Accidents, Occupational / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D003766:Dental Occlusion; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008337:Mandibular Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016602:Needlestick Injuries / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome