Comparative assessment of two methods of temporary intemaxillary immobilisation in the treatment of mandibular fractures-A prospective study

Background: The management of mandibular fractures has evolved greatly over the years from supportive bandages, splints, circum-mandibular wiring, extra oral pins to rigid fixation and more lately semi rigid fixation. Arch bar fixation has been the popular method for so long. The introduction of intraoral bone plating systems has widened the horizon. This prospective study is aimed at providing the clinician an evidence based recommendation in adopting suitable method. Objectives: Purpose of this study is to compare two different methods for intermaxillary immobilisation namely intermaxillary fixation screws and Erich arch bars. Materials and Methods: 24 patients with mandibular parasymphisis fractures with or without sub-condylar fractures, fulfilling the inclusion criteria were selected and grouped into two (group A and group B) with 12 patients in each by random sampling allocation. Group A patients received Intermaxillary fixation screws while in group B Erich arch bar fixation was done. Two groups were evaluated with respect to variables such as reduction of displaced fracture and stability of IMF, possible iatrogenic dental injuries, needle stick injury, time consumed for achieving intermaxillary fixation and evaluation of oral hygiene during the intermaxillary fixation period. Results: Significant differences were observed between the two groups with clear indication of Intermaxillary fixation screws being more beneficial to the patient and clinician especially in terms of time consumed, avoidance of needle stick injury and oral hygiene maintenance. Conclusion: Intermaxillary fixation screws are a better alternative to arch bars in achieving intermaxillary fixation in indicated cases.