Bone-screw mandible fixation: An intraoperative alternative to arch bars

Abstract

OBJECTIVES: Bone-screw mandible fixation (BSMF) is evaluated as an alternative to intraoperative arch-bar maxillomandibular fixation before plating of mandibular fractures. BSMF is achieved by wire ligation of opposing bone-screws placed in the maxilla and mandible. METHODS: A retrospective evaluation of 23 patients with 40 mandibular fractures who underwent man-dibular fracture repairs. BSMF was used instead of arch bars to ensure proper dental occlusion. All fractures were then plated, after which BSMF was removed before termination of anesthesia. RESULTS: Normal occlusion was observed in 21 patients (91.3%), Class II malocclusion was noted in 1 patient (4.3%), and 1 patient was edentulous. No complications related to the use of BSMF were observed. CONCLUSION: BSMF can serve as a viable alternative to arch-bar maxillomandibular fixation for obtaining temporary intraoperative occlusion. BSMF produces acceptable malocclusion rates and offers the advantages of decreased intraoperative time, lower risk for percutaneous and mucosal wire punctures, and ease of use.