title: Design and application of hybrid maxillomandibular fixation for facial bone fractures.
abstract: OBJECTIVE
  A novel maxillomandibular fixation (MMF) procedure using a skeletal anchorage screw (SAS) (in the maxilla) and an arch bar (in the mandible), which we call "hybrid maxillomandibular fixation," was explored in this study. The aims of the study were to examine the efficacy of our hybrid MMF method and to compare periodontal tissue health and occlusal rehabilitation among 3 MMF methods.
  
  
  METHODS
  In total, 112 patients who had undergone open reduction at the Department of Oral and Maxillofacial Surgery between September 2005 and December 2012 were selected for this study. The participants were assigned to one of the following groups: SAS (maxilla), SAS (mandible), SAS-arch bar, or arch bar-arch bar. Periodontal health was evaluated using the Gingival Index, and the perioperative occlusal reproducibility was evaluated using a score of 1 to 3. Statistical analysis was performed using parametric tests (Student t test or 1-way analysis of variance followed by post hoc Tukey test).
  
  
  RESULTS
  In the Gingival Index comparison performed 1 month after the surgery, only the group using the arch bars and wiring was significantly different from the other groups (P < 0.05). The occlusal reproducibility scores were not significantly different. The pain and discomfort of the patients were reduced in the hybrid MMF group.
  
  
  CONCLUSIONS
  The hybrid MMF takes advantage of MMF using both arch bars and SASs for mandibular fractures. In addition, it overcomes many problems presented by previous MMF methods.
authors.affiliation: From the Department of Oral and Maxillofacial Surgery, Hallym University College of Medicine, Anyang City, South Korea.
authors.forename: Kang-Nam
authors.initials: KN
authors.lastname: Park
authors.forename: Seung-Min
authors.initials: SM
authors.lastname: Oh
authors.forename: Chang-Youn
authors.initials: CY
authors.lastname: Lee
authors.forename: Jwa-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Byoung-Eun
authors.initials: BE
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005891:Gingivitis / Q000175:diagnosis; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010512:Periodontal Index; D015203:Reproducibility of Results; D016896:Treatment Outcome