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Erschienen in: Clinical Oral Investigations 10/2023

21.08.2023 | Research

Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial

verfasst von: Ighor Andrade Fernandes, Essam Ahmed Al-Moraissi, Endi Lanza Galvão, Saulo Gabriel Moreira Falci

Erschienen in: Clinical Oral Investigations | Ausgabe 10/2023

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Abstract

Objective

This randomized clinical trial aimed to compare the efficacy of Erich arch bars (EAB) and intermaxillary fixation (IMF) screws in reducing mandibular fractures during open reduction and internal fixation (ORIF).

Methods

A total of 28 patients with mandibular fractures were randomly allocated to either the EAB group or the IMF screws group. The study evaluated various parameters including occlusal stability, complications, duration of application, oral hygiene status, quality of life, and patient characteristics.

Results

The study found no significant differences in occlusal stability between the EAB and IMF screw groups. However, the application and removal times were longer for EAB compared to IMF screws. The EAB group showed a higher presence of biofilm on teeth, indicating poorer oral hygiene status compared to the IMF screws group. In terms of quality of life, patients in the EAB group reported worse results in the “handicap” domain at the 15th postoperative day. No significant differences were observed in other quality-of-life parameters. Patient characteristics were well distributed between the two groups, enhancing the reliability of the results.

Conclusion

Both EAB and IMF screws demonstrated comparable occlusal stability for minimally displaced mandibular fractures. However, IMF screws offered advantages such as shorter application and removal times, better oral hygiene maintenance, and potentially improved quality of life in the “handicap” domain. Further studies with larger sample sizes are necessary to validate these findings and explore the stability of IMF methods in cases requiring postoperative malocclusion correction or prolonged IMF.
Literatur
1.
Zurück zum Zitat Jain A, Taneja S, Rai A (2021) What is a better modality of maxillomandibular fixation: bone-supported arch bars or Erich arch bars? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 59:858–866CrossRefPubMed Jain A, Taneja S, Rai A (2021) What is a better modality of maxillomandibular fixation: bone-supported arch bars or Erich arch bars? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 59:858–866CrossRefPubMed
2.
Zurück zum Zitat Nandini GD, Balakrishna R, Rao J (2011) Self tapping screws v/s Erich arch bar for inter maxillary fixation: a comparative clinical study in the treatment of mandibular fractures. J Maxillofac Oral Surg 10:127–131CrossRefPubMedPubMedCentral Nandini GD, Balakrishna R, Rao J (2011) Self tapping screws v/s Erich arch bar for inter maxillary fixation: a comparative clinical study in the treatment of mandibular fractures. J Maxillofac Oral Surg 10:127–131CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Falci SG, Douglas-de-Oliveira DW, Stella PE, Santos CR (2015) Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review. Med Oral Patol Oral Cir Bucal 20:e494-499CrossRefPubMedPubMedCentral Falci SG, Douglas-de-Oliveira DW, Stella PE, Santos CR (2015) Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review. Med Oral Patol Oral Cir Bucal 20:e494-499CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Fernandes IA, Lopes ABS, Fonseca PG, da Silva TA, Rodrigues AB, Galvão EL et al (2021) Comparison between Erich arch bars and intermaxillary screws in maxillofacial fractures involving the dental occlusion: a meta-analysis. Int J Oral Maxillofac Surg 50:83–95CrossRefPubMed Fernandes IA, Lopes ABS, Fonseca PG, da Silva TA, Rodrigues AB, Galvão EL et al (2021) Comparison between Erich arch bars and intermaxillary screws in maxillofacial fractures involving the dental occlusion: a meta-analysis. Int J Oral Maxillofac Surg 50:83–95CrossRefPubMed
5.
Zurück zum Zitat Qureshi AA, Reddy UK, Warad NM, Badal S, Jamadar AA, Qurishi N (2016) Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: a comparative study and review of literature. Ann Maxillofac Surg 6:25–30CrossRefPubMedPubMedCentral Qureshi AA, Reddy UK, Warad NM, Badal S, Jamadar AA, Qurishi N (2016) Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: a comparative study and review of literature. Ann Maxillofac Surg 6:25–30CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Tepass A, Rolauffs B, Weise K, Bahrs SD, Dietz K, Bahrs C (2013) Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970–2009. Patient Saf Surg 7:34CrossRefPubMedPubMedCentral Tepass A, Rolauffs B, Weise K, Bahrs SD, Dietz K, Bahrs C (2013) Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970–2009. Patient Saf Surg 7:34CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ et al (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340:c869CrossRefPubMedPubMedCentral Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ et al (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340:c869CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Costa MD, Froes Junior GRT, Santos CN (2012) Evaluation of occlusal factors in patients with temporomandibular joint disorder. Dental Press J Orthod 17(6):61–68 Costa MD, Froes Junior GRT, Santos CN (2012) Evaluation of occlusal factors in patients with temporomandibular joint disorder. Dental Press J Orthod 17(6):61–68
9.
Zurück zum Zitat Alpert B, Antonyshyn O, Assael LA, Audigé L, Bentley R, RM Bos R et al (2012) Principles of internal fixation of the craniomaxillofacial skeleton trauma and orthognatic surgery. In: Ehrenfeld M, Manson PN, Prein J, AO Foundation. AO Foundation; Georg Thieme Verlag, Davos, Switzerland, Stuttgart Alpert B, Antonyshyn O, Assael LA, Audigé L, Bentley R, RM Bos R et al (2012) Principles of internal fixation of the craniomaxillofacial skeleton trauma and orthognatic surgery. In: Ehrenfeld M, Manson PN, Prein J, AO Foundation. AO Foundation; Georg Thieme Verlag, Davos, Switzerland, Stuttgart
10.
Zurück zum Zitat Gibbons AJ, Hodder SC (2003) A self-drilling intermaxillary fixation screw. Br J Oral Maxillofac Surg 41:48–49CrossRefPubMed Gibbons AJ, Hodder SC (2003) A self-drilling intermaxillary fixation screw. Br J Oral Maxillofac Surg 41:48–49CrossRefPubMed
11.
Zurück zum Zitat Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235PubMed Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235PubMed
12.
Zurück zum Zitat Sekar KSV, Natarajan PM, Kapasi AY (2017) Comparison of arch bar, eyelets and transmucosal screws for maxillo mandibular fixation in jaw fratcure. Biomed Pharmacol J 10:497–508CrossRef Sekar KSV, Natarajan PM, Kapasi AY (2017) Comparison of arch bar, eyelets and transmucosal screws for maxillo mandibular fixation in jaw fratcure. Biomed Pharmacol J 10:497–508CrossRef
13.
Zurück zum Zitat Rai A, Datarkar A, Borle RM (2011) Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study. J Oral Maxillofac Surg 69:3015–3018CrossRefPubMed Rai A, Datarkar A, Borle RM (2011) Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study. J Oral Maxillofac Surg 69:3015–3018CrossRefPubMed
14.
Zurück zum Zitat Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y (2017) Self-tapping intermaxillary fixation screw: an alternative to arch bar. J Contemp Dent Pract 18:147–151CrossRefPubMed Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y (2017) Self-tapping intermaxillary fixation screw: an alternative to arch bar. J Contemp Dent Pract 18:147–151CrossRefPubMed
15.
Zurück zum Zitat Vatsa P, Siddaraju A (2018) A comparative clinical study on self-drilling screws and Erich arch bars in mandibular fractures. International Journal of Applied Dental Sciences 4:212–217 Vatsa P, Siddaraju A (2018) A comparative clinical study on self-drilling screws and Erich arch bars in mandibular fractures. International Journal of Applied Dental Sciences 4:212–217
16.
Zurück zum Zitat Rothe TM, Kumar P, Shah N, Shah R, Mahajan A, Kumar A (2019) Comparative evaluation of efficacy of conventional arch bar, intermaxillary fixation screws, and modified arch bar for intermaxillary fixation. J Maxillofac Oral Surg 18:412–418CrossRefPubMed Rothe TM, Kumar P, Shah N, Shah R, Mahajan A, Kumar A (2019) Comparative evaluation of efficacy of conventional arch bar, intermaxillary fixation screws, and modified arch bar for intermaxillary fixation. J Maxillofac Oral Surg 18:412–418CrossRefPubMed
17.
Zurück zum Zitat Vartanian AJ, Alvi A (2000) Bone-screw mandible fixation: an intraoperative alternative to arch bars. Otolaryngol Head Neck Surg 123:718–721CrossRefPubMed Vartanian AJ, Alvi A (2000) Bone-screw mandible fixation: an intraoperative alternative to arch bars. Otolaryngol Head Neck Surg 123:718–721CrossRefPubMed
18.
Zurück zum Zitat Choi JW, Kim HB, Jeong WS, Kim SC, Koh KS (2019) Comparison between intermaxillary fixation with screws and an arch bar for mandibular fracture. J Craniofac Surg 30:1787–1789CrossRefPubMed Choi JW, Kim HB, Jeong WS, Kim SC, Koh KS (2019) Comparison between intermaxillary fixation with screws and an arch bar for mandibular fracture. J Craniofac Surg 30:1787–1789CrossRefPubMed
19.
Zurück zum Zitat Gordon KF, Reed JM, Anand VK (1995) Results of intraoral cortical bone screw fixation technique for mandibular fractures. Otolaryngol Head Neck Surg 113:248–252CrossRefPubMed Gordon KF, Reed JM, Anand VK (1995) Results of intraoral cortical bone screw fixation technique for mandibular fractures. Otolaryngol Head Neck Surg 113:248–252CrossRefPubMed
20.
Zurück zum Zitat Balihallimath L, Jain R, Mehrotra U, Rangnekar N (2018) To compare the efficiency of maxillomandibular fixation screws over Erich arch bar in achieving intermaxillary fixation in maxillofacial trauma: a clinical study. J Int Clin Dent Res Organ 10(1):27–31 Balihallimath L, Jain R, Mehrotra U, Rangnekar N (2018) To compare the efficiency of maxillomandibular fixation screws over Erich arch bar in achieving intermaxillary fixation in maxillofacial trauma: a clinical study. J Int Clin Dent Res Organ 10(1):27–31
21.
Zurück zum Zitat Pathak P, Thomas S, Bhargava D, Beena S (2019) A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich’s arch bar (CEAB). Oral Maxillofac Surg 23:285–289CrossRefPubMed Pathak P, Thomas S, Bhargava D, Beena S (2019) A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich’s arch bar (CEAB). Oral Maxillofac Surg 23:285–289CrossRefPubMed
22.
Zurück zum Zitat Pigadas N, Whitley SP, Roberts SA, McAlister K, Ameerally P, Avery CM (2008) A randomized controlled trial on cross-infection control in maxillofacial trauma surgery: a comparison of intermaxillary fixation techniques. Int J Oral Maxillofac Surg 37:716–722CrossRefPubMed Pigadas N, Whitley SP, Roberts SA, McAlister K, Ameerally P, Avery CM (2008) A randomized controlled trial on cross-infection control in maxillofacial trauma surgery: a comparison of intermaxillary fixation techniques. Int J Oral Maxillofac Surg 37:716–722CrossRefPubMed
23.
Zurück zum Zitat Hassan SFS, Kapoor M, Shah A (2018) Comparative evaluation of modified Erich’s arch bar, conventional Erich’s arch bar and intermaxillary fixation screws in maxillo-mandibular fixation: a prospective clinical study. Int J Med Res Prof 4:41–45 Hassan SFS, Kapoor M, Shah A (2018) Comparative evaluation of modified Erich’s arch bar, conventional Erich’s arch bar and intermaxillary fixation screws in maxillo-mandibular fixation: a prospective clinical study. Int J Med Res Prof 4:41–45
24.
Zurück zum Zitat Rothe TM, Kumar P, Shah N, Shah R, Kumar A, Das D (2018) Evaluation of efficacy of intermaxillary fixation screws versus modified arch bar for intermaxillary fixation. Natl J Maxillofac Surg 9:134–139CrossRefPubMedPubMedCentral Rothe TM, Kumar P, Shah N, Shah R, Kumar A, Das D (2018) Evaluation of efficacy of intermaxillary fixation screws versus modified arch bar for intermaxillary fixation. Natl J Maxillofac Surg 9:134–139CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat van den Bergh B, de Mol van Otterloo JJ, van der Ploeg T, Tuinzing DB, Forouzanfar T (2015) IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects. J Craniomaxillofac Surg 43:1004–1009CrossRefPubMed van den Bergh B, de Mol van Otterloo JJ, van der Ploeg T, Tuinzing DB, Forouzanfar T (2015) IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects. J Craniomaxillofac Surg 43:1004–1009CrossRefPubMed
Metadaten
Titel
Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial
verfasst von
Ighor Andrade Fernandes
Essam Ahmed Al-Moraissi
Endi Lanza Galvão
Saulo Gabriel Moreira Falci
Publikationsdatum
21.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 10/2023
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-023-05220-x

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