Poeschl Paul W, Ploder Oliver, Seemann Rudolf, Poeschl Ellen
University Hospital for Craniomaxillofacial and Oral Surgery, Vienna Medical University, Vienna, Austria.
J Oral Maxillofac Surg. 2008 Feb;66(2):336-41. doi: 10.1016/j.joms.2007.06.671.
The present work evaluated the success of maxillomandibular fixation (MMF) by intraoral cortical bone screws and specially designed metal hooks (Ottenhaken) in nondislocated or slightly dislocated mandibular fractures.
A total of 44 patients who sustained various types of mandibular fractures were treated at the University Hospital for Craniomaxillofacial and Oral Surgery, Vienna Medical School by MMF with Ottenhaken only. The patients were evaluated by preoperative and postoperative radiography, and clinical testing was performed by thermal testing with a cold spray and by assessing the degree of tooth mobility adjacent to the inserted screws. To determine the success of the treatment, various parameters, including screw or hook fracture, screw loosening, local infection of the punctured mucosa, and iatrogenic tooth damage, were considered.
The screws and hooks were successfully inserted and MMF was engaged with tight elastics in all cases. The most frequent complication was rupturing of the elastics, necessitating replacement. In 5 patients, local infection of the mucosa around the screw led to severe pain that was treated successfully with analgesics. The screws could be left in place in all 5 cases. Hook fracture and screw loosening each occurred in 1 patient. No iatrogenic injuries of the dental roots were noted. After screw removal, all wounds healed uneventfully.
The use of intraoral cortical bone screws and specially designed metal hooks (Ottenhaken) for MMF is a useful, valid alternative to arch bars that carries only rare, mild complications.
本研究评估了使用口内皮质骨螺钉和专门设计的金属钩（Ottenhaken）对无移位或轻度移位下颌骨骨折进行颌间固定（MMF）的成功率。
维也纳医科大学颅颌面与口腔外科大学医院共治疗了44例不同类型下颌骨骨折患者，仅使用Ottenhaken进行MMF治疗。通过术前和术后X线摄影对患者进行评估，并通过冷喷雾热测试以及评估插入螺钉附近牙齿的松动程度进行临床测试。为确定治疗的成功率，考虑了各种参数，包括螺钉或钩断裂、螺钉松动、穿刺黏膜局部感染以及医源性牙齿损伤。
所有病例中螺钉和钩均成功插入，MMF通过紧密弹性带固定。最常见的并发症是弹性带断裂，需要更换。5例患者中，螺钉周围黏膜局部感染导致严重疼痛，使用镇痛药成功治疗。所有5例患者的螺钉均可留在原位。钩断裂和螺钉松动各发生在1例患者中。未发现医源性牙根损伤。取出螺钉后，所有伤口均顺利愈合。
使用口内皮质骨螺钉和专门设计的金属钩（Ottenhaken）进行MMF是一种有用、有效的替代牙弓夹板的方法，仅伴有罕见、轻微的并发症。
