Our clinical experience of transalveolar screws in maxillomandibular fixation

Introduction: Transalveolar screws for achieving maxillomandibular fixation have been in clinical usage for the past three decades. Thisprospective clinical study aims to analyze the efficacy and potential complications of transalveolar screws in the management of mandibular fractures. Material and Methods: A prospective interventionalclinical study with 40 adult patients with minimally displaced mandibular fractures effecting the occlusion and requiring open reduction and internal fixation were selected. Maxillomandibular fixation was achieved using 2.0 mm diameter, 10-12 mm long, titanium transalveolar screws. The time required to achieve Maxillomandibular fixation using transalveolar screws was recorded. Intraoperative complications (glove perforation, screw breakage, screw redirection, soft tissue injury) and post-operative complications (iatrogenic root damage, tooth non-vitality, soft tissue injury) were recorded during follow up. The results were statistically evaluated using the Mean and Percentage tool. Results: The average time taken to achieve Maxillomandibular fixation was found to be 16.43 minutes, with three screw breakage out of 163 screws used. No glove perforation was observed. Iatrogenic dental damage was found to be 6.62% with additional soft tissue injury. Occlusal stability of the device was found to be satisfactory, though screw loosening in a few cases was observed. Conclusion: The overall incidence of intraoperative and postoperative complications with their sequelae were minimal and can be further decreased by taking appropriate precautions.