The safe and efficacious use of arch bars in patients during primary and mixed dentition: a challenge to conventional teaching.
BACKGROUND
Erich arch bars facilitate intermaxillary fixation, and traditional teaching questions and often argues against the use of arch bars in patients during primary and mixed dentition. Dental anatomy, risk of tooth avulsion, and potential disruption of developing permanent dentition are reasons cited. This study provides the only outcome data on the use of arch bars in children during primary and mixed dentition.


METHODS
Patients in primary and mixed dentition presenting with mandible fractures treated with arch bars from 2000 to 2010 were reviewed. Elements collected included demographics, medical history, fracture management, adverse outcomes, and dental health as determined by a pediatric dentist at follow-up.


RESULTS
A total of 154 mandible fractures in 79 patients were identified, with 23 patients (48 fractures) meeting inclusion criteria. Average age at injury was 9.10 years (range, 2.70 to 13.49 years), and average follow-up was 32.35 months (range, 0.43 to 131.84 months). Fracture types included condylar head (n = 9), condylar neck (n = 12), angle (n = 10), body (n = 4), and parasymphysis (n = 13) fractures. There were no periodontal defects, tooth avulsions, or disturbances to permanent dentition noted with regard to arch bar use.


CONCLUSIONS
These data demonstrate that arch bars can be safely used in children during primary and mixed dentition with no periodontal defects, tooth avulsions, or disturbances to permanent dentition. Despite traditional teaching, the authors demonstrate arch bar use to be efficacious and safe in children during primary or mixed dentition.


METHODS
Therapeutic, IV.
Pittsburgh, Pa. From the Divisions of Pediatric Plastic Surgery and Pediatric Dentistry, University of Pittsburgh.
Sanjay
S
Naran
John
J
Keating
Megan
M
Natali
Michael
M
Bykowski
Darren
D
Smith
Brian
B
Martin
Joseph E
JE
Losee
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003818:Dentition, Mixed; D005592:Fracture Fixation / Q000295:instrumentation*; D006801:Humans; D008337:Mandibular Fractures / Q000601:surgery*; D014094:Tooth, Deciduous