title: Conservative treatment of a mandibular condyle fracture: Comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial.
abstract: BACKGROUND
  A mandibular condyle fracture can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation (ORIF). Many IMF-modalities can be chosen, including IMF-screws (IMFS). This prospective multi-centre randomised clinical trial compared the use of IMFS with the use of arch bars in the treatment of mandibular condyle fractures.
  
  
  RESULTS
  The study population consisted of 50 patients (mean age: 31.8 years). Twenty-four (48%) patients were allocated in the IMFS group. Twenty-six (52%) patients were assigned to the arch bars group. In total 188 IMF-screws were used (5-12 screws per patient, mean 7.83 screws per patient). All pain scores were lower in the IMFS group. Three patients developed a malocclusion (IFMS-group: one patient, arch bars-group: two patients). Mean surgical time was significantly shorter in the IMFS group (59 vs. 126 min; p<0.001). There were no needlestick injuries (0%) in the IMFS group and eight (30.7%) in the arch bars group (p=0.003). One IMF-screw fractured on insertion (0.53%), one (0.53%) screw was inserted into a root. Six (3.2%) screws loosened spontaneously in four patients. Mucosal disturbances were seen in 22 patients, equally divided over both groups.
  
  
  CONCLUSIONS
  Considering the advantages and the disadvantages of IMFS, and observing the results of this study, the authors conclude that IMFS provide a superior method for IMF. IMFS are safer for the patients and surgeons.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kennemer Gasthuis Hospital, P.O. Box 417, 2000 AK, Haarlem, The Netherlands; Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Electronic address: b.vanden.bergh@kg.nl.
authors.forename: B
authors.initials: B
authors.lastname: van den Bergh
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical Center Alkmaar, P.O. Box 501, 1800 AM, Alkmaar, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Blankestijn
authors.affiliation: Research Center Linnaeus Institute, Kennemer Gasthuis Hospital, P.O. Box 417, 2000 AK, Haarlem, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van der Ploeg
authors.affiliation: Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: D B
authors.initials: DB
authors.lastname: Tuinzing
authors.affiliation: Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Forouzanfar
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D001864:Bone Wires / Q000009:adverse effects; D000072700:Conservative Treatment / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D007431:Intraoperative Complications; D019248:Jaw Fixation Techniques / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000628:therapy*; D008875:Middle Aged; D060051:Occupational Injuries / Q000209:etiology; D024343:Open Bite / Q000209:etiology; D061646:Operative Time; D010147:Pain Measurement / Q000379:methods; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000209:etiology; D055815:Young Adult
keywords: Arch bars; IMF-screws (IMFS); Intermaxillary fixation (IMF); Mandibular condyle fracture; Mandibular fracture