Sandhu Yashmeet Kaur, Padda Sarfaraz, Kaur Tejinder, Dhawan Amit, Kapila Sarika, Kaur Jasmine
Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India.
Department of Oral Medicine and Radiology, Ibn Sina National College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia.
J Maxillofac Oral Surg. 2018 Jun;17(2):211-217. doi: 10.1007/s12663-017-1046-3. Epub 2017 Sep 21.
Maxillomandibular fixation is required in nearly all cases of facial fractures which can be achieved by conventional dental wiring techniques or newer methods using transalveolar screws.
A prospective randomized clinical study divided into two groups with thirty adult patients each with mandibular fractures was undertaken comparing the Maxillomandibular fixation technique using transalveolar screws and Erichs arch bar. Total time taken, rate of glove perforation, intraoperative and postoperative complications were noted in both the groups.
The time taken for maxillomandibular fixation in minutes and rate of glove perforation was found to be statistically significantly less for transalveolar group compared to arch bar group ( < 0.05). However, there was no significant difference found in the oral hygiene and gingival status using the Glass index and Gingival index. The rate of screw breakage (04.67%), wire breakage (05.12%), non-vitality due to iatrogenic dental damage (01.66%), soft tissue injury and tooth loss were some of the noted complications during the study.
We found that transalveolar group offered advantages like less time taken with a definite decreased risk of percutaneous injury, while the iatrogenic complications like dental damage can be reduced by taking adequate precautions.
几乎所有面部骨折病例都需要进行颌间固定，这可以通过传统的牙弓结扎技术或使用经牙槽螺钉的更新方法来实现。
进行了一项前瞻性随机临床研究，将30例成年下颌骨骨折患者分为两组，比较使用经牙槽螺钉的颌间固定技术和 Erichs 牙弓夹板。记录两组的总时间、手套穿孔率、术中及术后并发症。
与牙弓夹板组相比，经牙槽螺钉组的颌间固定时间（以分钟计）和手套穿孔率在统计学上显著更低（<0.05）。然而，使用格拉斯指数和牙龈指数评估时，口腔卫生和牙龈状况没有显著差异。研究中记录的一些并发症包括螺钉断裂率（04.67%）、钢丝断裂率（05.12%）、医源性牙齿损伤导致的牙髓坏死（01.66%）、软组织损伤和牙齿脱落。
我们发现经牙槽螺钉组具有优势，如所需时间更少，经皮损伤风险明显降低，同时通过采取适当预防措施可以减少医源性牙齿损伤等并发症。
