title: Bone-supported arch bars are associated with comparable outcomes to Erich arch bars in the treatment of mandibular fractures with intermaxillary fixation.
abstract: OBJECTIVE
  Titanium arch bars that are directly fixated to the maxilla and mandible with self-drilling locking screws combine features of Erich arch bars and bone-supported devices and present an alternative method of intermaxillary fixation (IMF) that possesses potential advantages over existing techniques. The objective of this study was to compare IMF using this device with Erich arch bars secured with circum-dental wires.
  
  
  METHODS
  A retrospective cohort study was performed of patients who were surgically treated for mandibular fractures from 2012 through 2013. The primary predictor variable was fixation technique, which was IMF using Erich arch bars secured with circum-dental wires (group I) or titanium arch bars fixated with maxillary and mandibular screws (group II). The outcome variables were complication rates, time necessary for device application and removal, glove perforation rate, and cost. Statistical analysis was performed with InStat (GraphPad, Inc, La Jolla, CA) using the Fisher, χ(2), or Mann-Whitney test, as appropriate.
  
  
  RESULTS
  Twenty-five consecutive cases in group I and in group II were reviewed. There were 43 male patients (86%) and 7 female patients (14%) with a mean age of 28.4 years. Mean follow-up was 2.0 months. Overall complication rates for groups I and II were similar (16.0% vs 12.0%, respectively; P = 1.00). In group II, there were 3 instances of delayed wound healing at the sites of gingivobuccal incisions attributed to the close proximity of the arch bar eyelets. The time necessary for device application was faster in group II than in group I (42 vs 62 minutes, respectively; P = .02).
  
  
  CONCLUSIONS
  Bone-supported arch bars may be a comparable alternative to Erich arch bars secured with circum-dental wires for IMF. Careful planning of transoral incisions in relation to locking screw eyelets may help minimize wound complications.
authors.affiliation: Assistant Professor, Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus, OH. Electronic address: Albert.Chao@osumc.edu.
authors.forename: Albert H
authors.initials: AH
authors.lastname: Chao
authors.affiliation: Resident, Department of Plastic and Reconstructive Surgery, The Ohio State University, Columbus, OH.
authors.forename: John
authors.initials: J
authors.lastname: Hulsen
mesh_terms: D003724:Dental Arch / Q000473:pathology*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome