Kendrick Douglas E, Park Chan M, Fa Jesse M, Barber Jacob S, Indresano A Thomas
Oakland, Calif. From the University of the Pacific School of Dentistry, Highland Hospital Division of Oral and Maxillofacial Surgery.
Plast Reconstr Surg. 2016 Jan;137(1):142e-150e. doi: 10.1097/PRS.0000000000001920.
The SMARTLock Hybrid MMF System from Stryker is a newer approach for maxillomandibular fixation. This study was performed to determine the clinical application, complications, radiographic findings, and cost effectiveness of the SMARTLock system.
A retrospective cohort study was performed with the SMARTLock system over 6 months. Demographics, history, fracture location, placement/removal time, and complications were obtained, along with cost analysis.
The authors identified 35 patients with the SMARTLock system. Twenty-four patients remained after exclusion criteria. There were 19 male patients (79 percent) and five female patients (21 percent), with a mean age of 30.7 years. The mean application time of the SMARTLock system was 14.4 minutes, and the mean removal time was 10.5 minutes. Three hundred nineteen total screws were placed. The number and percentage of patients with complications associated with the SMARTLock system were as follows: mucosal overgrowth [n = 9 (38 percent)], screw loosening [n = 4 (17 percent)], lip irritation [n = 4 (17 percent)], malocclusion [n = 3 (13 percent)], nonunion [n = 1 (4 percent)], wound dehiscence [n = 1 (4 percent)], screw loss [n = 1 (4 percent)], tooth devitalization [n = 1 (4 percent)], loose plate [n = 1 (4 percent)], and plate fracture [n = 1 (4 percent)]. There were no instances of sharps exposure, tooth loss, or infection. One tooth required endodontic therapy. The number of screws that damaged teeth on cone-beam computed tomographic imaging was 24 (7.5 percent). The cost analysis showed similar cost between Erich arch bars and the SMARTLock system.
This study suggests that the SMARTLock Hybrid MMF System is safe and easy to use, and with a cost similar to that of Erich arch bars. Appropriate treatment planning and previous surgical experience should be used to determine appropriate case selection, as this system is not ideal in all situations.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
史赛克公司的SMARTLock Hybrid MMF系统是一种用于上颌下颌固定的新方法。本研究旨在确定SMARTLock系统的临床应用、并发症、影像学表现及成本效益。
对使用SMARTLock系统超过6个月的患者进行回顾性队列研究。收集患者的人口统计学资料、病史、骨折部位、固定/拆除时间及并发症，并进行成本分析。
作者共纳入35例使用SMARTLock系统的患者。排除标准后，剩余24例患者。其中男性19例（79%），女性5例（21%），平均年龄30.7岁。SMARTLock系统的平均固定时间为14.4分钟，平均拆除时间为10.5分钟。共植入319枚螺钉。与SMARTLock系统相关的并发症患者数量及百分比分别为：黏膜增生[n = 9（38%）]、螺钉松动[n = 4（17%）]、唇部刺激[n = 4（17%）]、咬合不正[n = 3（13%）]、骨不连[n = 1（4%）]、伤口裂开[n = 1（4%）]、螺钉丢失[n = 1（4%）]、牙齿失活[n = 1（4%）]、钢板松动[n = 1（4%）]和钢板骨折[n = 1（4%）]。未发生锐器伤、牙齿脱落或感染。1颗牙齿需要进行牙髓治疗。锥形束计算机断层扫描成像显示有24枚螺钉（7.5%）损伤牙齿。成本分析显示，埃里希牙弓夹板与SMARTLock系统的成本相似。
本研究表明，SMARTLock Hybrid MMF系统安全易用，成本与埃里希牙弓夹板相似。由于该系统并非在所有情况下都理想，因此应根据适当的治疗计划和既往手术经验来确定合适的病例选择。
临床问题/证据级别：治疗性，IV级。
