Anslem Osasuyi, Eyituoyo Okoturo, Olabode Ogunbanjo V, Ademola Olaitan A, Adesina Ayodele O
Oral and Maxillofacial Surgery, Nigerian Air Force Hospital, Nigerian Air Force Base, Kaduna, Nigeria.
Head and Neck Surgical Oncology Division, Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria.
Oral Maxillofac Surg. 2017 Jun;21(2):233-240. doi: 10.1007/s10006-017-0622-5. Epub 2017 Apr 6.
The main goal of treatment of mandibular fractures is to restore normal dental occlusion and promote appropriate bone healing and a normal mouth opening. Recently, there has been a resurgent interest in the use of screws for intermaxillary fixation of mandibular fractures. This study was therefore designed to determine how the clinical outcomes of the use of screws for intermaxillary fixation compare with the use of miniplates in the treatment of mandibular fractures in Nigeria.
The objectives of this study are as follows: 1. To compare the clinical outcomes of the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation with 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures in Lagos, Nigeria 2. To determine the clinical outcomes in the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation (IMF) and 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures 3. To compare the complications associated with the use of 2.0 mm × 9.0 mm screws for IMF and 2.0 mm noncompression miniplates in the treatment of mandibular fractures METHODOLOGY: This randomized controlled clinical study was carried out at the Department of Oral and Maxillofacial Surgery of the study institution. Subjects with simple unilateral mandibular fractures who met the inclusion criteria were randomly allocated into the study (intermaxillary fixation screw) and control (miniplate) groups through balloting. Factors assessed and compared during and after the procedures included intraoperative pain, postoperative nerve impairment, postoperative occlusion, limitation of mouth opening, incidence of hardware failure, incidence of infection and non-union. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20.
A total of 56 subjects participated in the study, with 28 subjects in each group. Majority (91%) of the subjects were male. Road traffic crash was the highest aetiological factor while sport was the least (3.6%). A higher proportion (25.0%) of subjects in the miniplate group had major complications compared with 14.3% in the IMF screw group. There was no statistically significant association between site of mandibular fracture, time elapsed before treatment and complications (p < 0.05). All cases of mandibular fractures healed successfully at 6 weeks.
The use of screws for IMF is as effective as 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures.
下颌骨骨折治疗的主要目标是恢复正常的牙合关系，促进适当的骨愈合和正常的开口度。最近，人们对使用螺钉进行下颌骨骨折的颌间固定重新产生了兴趣。因此，本研究旨在确定在尼日利亚，使用螺钉进行颌间固定与使用微型钢板治疗下颌骨骨折的临床效果相比如何。
本研究的目的如下：1. 比较在尼日利亚拉各斯使用2.0毫米×9.0毫米螺钉进行颌间固定与使用2.0毫米非加压微型钢板治疗单纯性单侧下颌骨骨折的临床效果；2. 确定使用2.0毫米×9.0毫米螺钉进行颌间固定（IMF）和2.0毫米非加压微型钢板治疗单纯性单侧下颌骨骨折的临床效果；3. 比较使用2.0毫米×9.0毫米螺钉进行IMF和使用2.0毫米非加压微型钢板治疗下颌骨骨折相关的并发症。
本随机对照临床研究在研究机构的口腔颌面外科进行。符合纳入标准的单纯性单侧下颌骨骨折患者通过抽签随机分为研究组（颌间固定螺钉组）和对照组（微型钢板组）。在手术过程中和手术后评估和比较的因素包括术中疼痛、术后神经损伤、术后咬合、开口受限、内固定失败发生率、感染发生率和骨不连发生率。使用社会科学统计软件包（SPSS）20版进行数据分析。
共有56名受试者参与研究，每组28名。大多数（91%）受试者为男性。道路交通事故是最主要的病因，而运动是最少见的病因（占3.6%）。微型钢板组中较高比例（25.0%）的受试者出现了严重并发症，而颌间固定螺钉组为14.3%。下颌骨骨折部位、治疗前经过的时间与并发症之间无统计学显著关联（p < 0.05）。所有下颌骨骨折病例在6周时均成功愈合。
在治疗单纯性单侧下颌骨骨折方面，使用螺钉进行颌间固定与使用2.0毫米非加压微型钢板同样有效。
