Maxillomandibular fixation using intraoral cortical bone screws and specially designed metal hooks (Ottenhaken) in the conservative treatment of mandibular fractures.
OBJECTIVE
The present work evaluated the success of maxillomandibular fixation (MMF) by intraoral cortical bone screws and specially designed metal hooks (Ottenhaken) in nondislocated or slightly dislocated mandibular fractures.


METHODS
A total of 44 patients who sustained various types of mandibular fractures were treated at the University Hospital for Craniomaxillofacial and Oral Surgery, Vienna Medical School by MMF with Ottenhaken only. The patients were evaluated by preoperative and postoperative radiography, and clinical testing was performed by thermal testing with a cold spray and by assessing the degree of tooth mobility adjacent to the inserted screws. To determine the success of the treatment, various parameters, including screw or hook fracture, screw loosening, local infection of the punctured mucosa, and iatrogenic tooth damage, were considered.


RESULTS
The screws and hooks were successfully inserted and MMF was engaged with tight elastics in all cases. The most frequent complication was rupturing of the elastics, necessitating replacement. In 5 patients, local infection of the mucosa around the screw led to severe pain that was treated successfully with analgesics. The screws could be left in place in all 5 cases. Hook fracture and screw loosening each occurred in 1 patient. No iatrogenic injuries of the dental roots were noted. After screw removal, all wounds healed uneventfully.


CONCLUSIONS
The use of intraoral cortical bone screws and specially designed metal hooks (Ottenhaken) for MMF is a useful, valid alternative to arch bars that carries only rare, mild complications.
Poeschl
Paul W
PW
University Hospital for Craniomaxillofacial and Oral Surgery, Vienna Medical University, Vienna, Austria. maxillofacials@hotmail.com
Ploder
Oliver
O
Seemann
Rudolf
R
Poeschl
Ellen
E
D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001863:Bone Screws / Q000009:adverse effects*; D003762:Dental Instruments; D004548:Elasticity; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D018677:Tooth Injuries / Q000517:prevention & control; D014092:Tooth Root / Q000293:injuries; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000658:Amoxicillin