title: Severe tooth loss after root damage caused by predrilled intermaxillary fixation screw: a case report.
abstract: Intermaxillary fixation (IMF) with screws is routinely used as a conservative therapy or to obtain normal occlusion during the surgical procedure of open reduction and internal fixation for treating mandibular fractures. The risk of iatrogenic dental damage caused by interdental drilling is widely known. Several side effects are described, including loss of response to pulp sensibility testing, root fracture, and, loss of the tooth. This is a case report about a young man who had undergone temporary IMF treatment with a single proven root damage. The patient did not appear for follow-up but he presented 5 years afterward with local purulent osteomyelitis concerning the affected and the adjacent teeth. Osteotomy and extraction of two premolars and one molar were necessary for rehabilitation. This case report illustrates the importance of careful use of predrilled IMF screws and the necessity of frequent follow-ups in cases of proven tooth root damage due to IMF treatment.
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Oral and Maxillofacial Surgery, Berlin, Germany. stefan.hartwig@charite.de.
authors.forename: Stefan
authors.identifier: http://orcid.org/0000-0003-2193-4569
authors.initials: S
authors.lastname: Hartwig
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Doll
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
authors.forename: Jan Oliver
authors.initials: JO
authors.lastname: Voss
authors.affiliation: Charité - Universitätsmedizin Berlin, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
authors.forename: Jan Dirk
authors.initials: JD
authors.lastname: Raguse
mesh_terms: D001863:Bone Screws; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008337:Mandibular Fractures; D016388:Tooth Loss; D014092:Tooth Root; D055815:Young Adult
keywords: IMFS; intermaxillary fixation; predrilled screws; tooth damage; transgingival fixation