Routine Screening Radiography for Retained Wire Following Arch Bar Removal Is Not Indicated.
OBJECTIVE
To estimate the screening test value of routine radiography after arch bar wire removal by assessing the incidence of retained wires and the importance of their sequelae.


METHODS
This was a retrospective medical record review. Records of arch bar removal procedures were examined and divided into those screened with radiography after removal (screen group) and those that were not screened (comparison group). The incidence of retained wire was calculated for each group. Study variables included wire-related radiographic or clinical findings.


RESULTS
Records of 546 mandible fractures were reviewed; 95 met the study criteria. Most exclusions were due to lack of arch bars, missing postoperative radiographs, or insufficient postoperative documentation. Of the 55 records in the screen group, 1 wire was detected (2%); of the 40 records in the comparison group, 1 wire was detected (3%). The total incidence of retained wire findings was not statistically different between the 2 groups and there were no adverse wire-related sequelae reported by any of the 95 patients.


CONCLUSIONS
Because of the low incidence of retained wires and wire-related sequelae, routine imaging after wire removal is probably not an effective screening test for retained wire and should be limited to situations in which there is clinical suspicion of retained wire.
Resident, Department of Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, OR.
Savannah
S
Gelesko
Dental Student, School of Dentistry, Oregon Health & Science University, Portland, OR.
Devin
D
Wahlstrom
Associate Professor, Departments of Oral and Maxillofacial Surgery and Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR. Electronic address: engelsta@ohsu.edu.
Mark
M
Engelstad
D000293:Adolescent; D000328:Adult; D001864:Bone Wires; D015331:Cohort Studies; D020878:Device Removal; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D005881:Gingiva / Q000000981:diagnostic imaging; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation*; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000628:therapy; D008875:Middle Aged; D011862:Radiography, Panoramic / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult