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      A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System

      research-article
      Author(s): , MD * , , BS † , , MD, MPH * , , MD, DMD, FACS, FRCS * ,
      Publication date (Electronic):
      Journal: Plastic and Reconstructive Surgery Global Open
      Publisher: Wolters Kluwer Health

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          Summary:

          Establishing anatomic reduction of an edentulous mandible fracture is a frequently acknowledged challenge in craniomaxillofacial trauma surgery. In this study, we report a novel method for the reduction of the edentulous mandible fracture, via fabrication of modified Gunning splints using existing dentures and SMARTLock hybrid arch bars. This technique dramatically simplifies the application of an arch bar to dentures, obviates the need for the fabrication of impressions and custom splints, and eliminates the lag time associated with the creation of splints. Furthermore, this method may be used with or without adjunctive rigid internal fixation. The technique described herein of creating Gunning splints with SMARTLock hybrid arch bars provides surgeons with a simple, rapid, single-stage solution for reduction of mandibular fractures in the edentulous patient.

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          Most cited references16

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          Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study.

          Anshul Rai, Abhay Datarkar, Rajeev Borle (2011)
          The aim of this study is to see the efficacy of maxillomandibular fixation (MMF) screws with arch bars and to compare the plaque index in between 2 methods of MMF. This study is a randomized clinical trial. The study sample was derived from the population of patients who reported to Department of Oral and Maxillofacial Surgery, Wardha, Maharasthra, India between October 2006 and September 2008 and who required MMF. The patients were assessed for the time required in minutes for the placement and removal of screws and arch bar. Postoperative stability after achieving the MMF of both groups was analyzed and the plaque that was accumulated in both groups was evaluated by using TURESKY-GILMORE-GLICKMAN modification of the QUIGLEY-HEIN plaque index. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Inc, Chicago, IL) using the χ(2) test and Student t test. The average working time for placement and removal of MMF screws is 18.67 minutes and 10.20 minutes, respectively, and for arch bars is 95.06 minutes and 29 minutes, respectively. The mean value of plaque index in group I is 1.88 and in group II is 2.69. It signifies that plaque deposition was more in group II. No occlusal disturbance was seen in both groups. Incidence of MMF screws causing damage to tooth root is 5.81% and incidence of screw breakage was seen in 3.33% of patients. Oral hygiene maintenance is better in patients with MMF screws than with arch bars with fewer complications and less operating time. Erich arch bars are the preferred choice in patients who require long-term MMF, because the screws start loosening after 5 to 6 weeks. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
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            Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: A comparative study and review of literature

            Ahtesham Ahmad Qureshi, Umesh Reddy, N. M. Warad … (2016)
            Objective: Various techniques have been employed from time to time to achieve maxillomamdibular fixation. Although arch bars provide an effective and versatile means of maxillomandibular fixation, their use is not without shortcomings. However the introduction of intermaxillary fixation screws (IMF) has eliminated many of these issues of arch bars. The aim of the present study was to compare the advantages and disadvantages of intermaxillary fixation screws over the Erich arch bars in mandibular fractures. Materials and Methods: Sixty dentulous patients who reported to Department of Oral and Maxillofacial Surgery, Al-Ameen Dental College and Hospital, Bijapur with mandibular fractures and required intermaxillary fixation as a part of treatment plan followd by open reduction and internal fixation under GA were selected and randomly divided into 2 groups of 30 patients each that is Group A and Group B. Group A included patients who received intermaxillary fixation with Erich arch bars. Group B includes patients who received intermaxillary fixation with IMF Screws. The parameters compared in both the groups included, surgical time taken, gloves perforation, post-operative occlusion, IMF stability, oral hygiene, patient acceptance and comfort and non-vitality characteristics. Results: The average surgical time taken and gloves perforations were more in Group A,the patient acceptance and oral hygiene was better in Group B, there was not much statistically significant difference in postoperative occlusion and IMF stability in both groups. Accidental root perforation was the only limitation of IMF screws. Conclusion: Intermaxillary fixation with IMF screws is more efficacious compared to Erich arch bars in the treatment of mandibular fractures.
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              Management of atrophic mandible fractures.

              Matthew J Madsen, Richard H Haug, Bryan Christensen … (2009)
              Traumatic facial fractures that were once rarely encountered now present with increasing frequency in the elderly population. Included in this group of fractures are those of the atrophic edentulous mandible. As patients age and become edentulous, atrophy of the mandibular alveolar ridges and adjacent basal bone reduces bony surface area, bone density, and blood supply, making the mandible more brittle and increasing the likelihood of mandibular fracture during a traumatic event. Surgical treatment of these fractures has become more predictable and less morbid. However, because these fractures present so infrequently, many surgeons lack the relevant experience in handling them, and thus find the reduction and fixation of such injuries difficult. A number of techniques have been employed to treat this injury. This article reviews the more common modalities and presents updates on accepted surgical treatments.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Plast Reconstr Surg Glob Open
                Journal ID (iso-abbrev): Plast Reconstr Surg Glob Open
                Journal ID (publisher-id): GOX
                Title: Plastic and Reconstructive Surgery Global Open
                Publisher: Wolters Kluwer Health
                ISSN (Electronic): 2169-7574
                Publication date (Electronic): 05 September 2017
                Publication date Collection: September 2017
                Volume: 5
                Issue: 9
                Electronic Location Identifier: e1473
                Affiliations
                From the [* ]Department of Surgery, Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.; and [† ]Duke University School of Medicine, Durham, N.C.
                Author notes
                David B. Powers, MD, DMD, FACS, FRCS, Division of Plastic, Maxillofacial, and Oral Surgery, 40 Duke Medicine Circle, Duke University Medical Center, DUMC 2955, Durham, NC 27710, E-mail: David.Powers@ 123456duke.edu
                Article
                Accession ID: 00025
                DOI: 10.1097/GOX.0000000000001473
                PMC ID: 5640350
                SO-VID: 97cd56e1-9649-4f4b-9c49-db61312a1aa9
                Copyright © Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                Date received : 3 May 2017
                Date accepted : 11 July 2017
                Categories
                Subject: Ideas and Innovations
                Custom metadata
                OPEN-ACCESS TRUE

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