Rai Anshul, Datarkar Abhay, Borle Rajeev, Rai Monika
Department of Oral and Maxillofacial Surgery, Rishiraj Dental College, Bhopal, India.
J Oral Maxillofac Surg. 2012 Aug;70(8):1914-7. doi: 10.1016/j.joms.2012.04.010.
The intention of this study was to compare the efficacy of eyelet wiring and direct interdental (Gilmer) wiring for achieving intermaxillary fixation (IMF).
This study was a prospective randomized clinical trial. The study sample was derived from the population of patients who underwent IMF at the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Wardha, India, between October 2008 and September 2010. The time required for placement and removal (in minutes) was compared between the eyelet wiring and direct interdental wiring techniques. Postoperative stability after achieving IMF was analyzed in the 2 groups. The plaque accumulation in both groups was evaluated using the Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index. Complications in the form of soft tissue injury, glove puncture, and trauma to the operator's finger were also recorded. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Chicago, IL) using the χ(2) test and Student t test.
The mean working time for placement and removal of eyelet wiring (group I) was 18.00 minutes and 9.67 minutes, respectively. For direct interdental wiring (group II), it was 30.50 minutes and 23.12 minutes, respectively. The mean plaque index values were 1.78 and 2.54 for groups I and II, respectively, which signifies a higher plaque deposition in group II. No occlusal disturbance was seen in either group. The incidences of glove perforation, soft tissue trauma, and trauma to the operator's finger were higher in group II.
Eyelet wiring is preferable to direct interdental wiring as evidenced by fewer complications, and requires a shorter operating time in patients with minimally displaced fractures.
本研究旨在比较小孔结扎术和直接牙间(吉尔默)结扎术在实现颌间固定(IMF)方面的疗效。
本研究为前瞻性随机临床试验。研究样本来自2008年10月至2010年9月期间在印度瓦尔达市沙拉德·帕瓦尔牙科学院口腔颌面外科接受颌间固定的患者群体。比较了小孔结扎术和直接牙间结扎术在放置和拆除(以分钟计)所需的时间。对两组在实现颌间固定后的术后稳定性进行了分析。使用Quigley-Hein菌斑指数的Turesky-Gilmore-Glickman改良法评估两组的菌斑积聚情况。还记录了软组织损伤、手套穿刺和术者手指创伤等形式的并发症。使用适用于Windows的SPSS统计软件8.0版(SPSS,伊利诺伊州芝加哥)进行统计分析,采用χ(2)检验和学生t检验。
小孔结扎术组(第一组)放置和拆除的平均工作时间分别为18.00分钟和9.67分钟。对于直接牙间结扎术组(第二组),分别为30.50分钟和23.12分钟。第一组和第二组的平均菌斑指数值分别为1.78和2.54,这表明第二组的菌斑沉积更高得到。两组均未观察到咬合干扰。第二组手套穿孔、软组织创伤和术者手指创伤的发生率更高。
小孔结扎术比直接牙间结扎术更可取,并发症更少证明了这一点,并且对于骨折移位最小的患者,所需手术时间更短。