Satpute Ashish Shrikant, Mohiuddin Syed Ahmed, Doiphode Amol Madhukar, Kulkarni Sujay Sanjay, Qureshi Ahtesham Ahmad, Jadhav Swapnil Bharat
Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India.
Oral Maxillofac Surg. 2018 Dec;22(4):419-428. doi: 10.1007/s10006-018-0723-9. Epub 2018 Oct 9.
Intermaxillary fixation (IMF) is a fundamental principle in the management of mandibular fractures but with recent advent of open reduction and internal fixation (ORIF), use of IMF is almost limited intraoperatively. Therefore, we compared the efficacy of Erich arch bar versus embrasure wires for intraoperative IMF in mandibular fractures.
This prospective study was comprised of 50 patients with mandibular fractures who required ORIF with intraoperative IMF. Patients were categorized into two groups of 25 patients each: Erich arch bar technique was used for group A and embrasure wire technique for group B. Parameters were time taken for IMF, needle stick injury, occlusal stability, iatrogenic complications, and periodontal status of patients.
Chi-squared test and unpaired t test analyses was run on IBM SPSS 21.0 version (2015) software.
Mean time for placing embrasure wire (3.48 min) was significantly less than that for Erich arch bar (48.08 min). Needle stick injury rates to the operator as well as the assistants were significantly less when using the embrasure wire than the Erich arch bar. The Erich arch bar had significantly superior postoperative occlusion stability. Iatrogenic injury was more common when placing the Erich arch bar than the embrasure wire. Postoperative oral hygiene status was good in patients that received the embrasure wire.
Embrasure wire technique is a quick, easy, and reliable technique for minimally or moderately displaced fractured mandible and had better clinical outcomes than did patients that underwent the Erich arch bar technique.
颌间固定(IMF)是下颌骨骨折治疗的一项基本原则,但随着近年来切开复位内固定(ORIF)技术的出现,术中颌间固定的应用几乎仅限于手术过程中。因此,我们比较了用于下颌骨骨折术中颌间固定的 Erich 牙弓夹板与牙间结扎丝的疗效。
这项前瞻性研究纳入了 50 例需要进行切开复位内固定术并在术中进行颌间固定的下颌骨骨折患者。患者被分为两组,每组 25 例:A 组采用 Erich 牙弓夹板技术,B 组采用牙间结扎丝技术。观察指标包括颌间固定所需时间、针刺伤、咬合稳定性、医源性并发症以及患者的牙周状况。
使用 IBM SPSS 21.0 版本(2015 年)软件进行卡方检验和非配对 t 检验分析。
放置牙间结扎丝的平均时间(3.48 分钟)明显短于 Erich 牙弓夹板(48.08 分钟)。使用牙间结扎丝时,术者及助手的针刺伤发生率明显低于 Erich 牙弓夹板。Erich 牙弓夹板术后咬合稳定性明显更好。放置 Erich 牙弓夹板时医源性损伤比牙间结扎丝更常见。接受牙间结扎丝治疗的患者术后口腔卫生状况良好。
牙间结扎丝技术对于轻度或中度移位的下颌骨骨折是一种快速、简便且可靠的技术,其临床效果优于采用 Erich 牙弓夹板技术的患者。