Comparative Assessment between a New Technique for Maxillomandibular Fixation and the Conventional Technique - A Pilot Study

Abstract

Background: Advancements in surgery aim to make procedures atraumatic and reduce operative time. Techniques for interdental wiring, like Erich’s arch bar fixation, have seen improvements over time. Maxillomandibular fixation (MMF) is the oldest and most widely used technique of immobilization of jaws for management of facial trauma. Although eyelet wiring provides sufficient immobilization, it has a number of disadvantages. It is a cumbersome procedure and requires much time specially for trainees to pass the wires interdentally, as well as high chances of glove perforation. Many simple modifications have been tried in reducing application time and hence increasing patient comfort. The aim of this study is to evaluate the efficacy of the new instrument in reducing intra operative time, patient’s oral hygiene and increasing the safety of operator.

Materials and methodology: Using simple randomization, twenty participants were included in the study, and they were divided into group A (experimental group) in which embrasure screw and cover was used. While conventional technique of eyelet wiring was used in Group B (control group). Followed by IMF using wire or elastic. Similar post-operative instructions and medications were given to patients in both groups. Patients were recalled at regular intervals for checkup and assessment was done for operative time, glove perforation, occlusal stability and plaque accumulation.

Results: It was found that the difference in the mean age of the subjects between the groups was statistically non-significant. The mean intra-operative time in Group A was significantly shorter than that in Group B. All the subjects irrespective of the group, both intra-operatively and post-operative showed stability of the fractured fragments. There was no incidence of glove perforation in Group A whereas in Group B, the incidence was 60%. On comparing oral hygiene, it was found on post-operative day 21, the PI score in Group B was significantly higher compared to Group A while intra-group comparison showed significant increase in plaque score in both groups at each subsequent visit.

Conclusion: The technique is time-saving and more comfortable to operator as well as patient over conventional use of eyelet wiring for maxillomandibular fixation [MMF].