Cranial Maxillofac Trauma Reconstruction 2017; 10(04): 278-280
DOI: 10.1055/s-0037-1601864
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment Outcomes for Isolated Maxillary Complex Fractures with Maxillomandibular Screws

Rahul Gorka1, Amish Jayantilal Gohil1, Ashish Kumar Gupta1, Santosh Koshy2
  • 1Department of Plastic, Burns, Reconstructive and Microvascular Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  • 2Department of Dental Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
Further Information

Publication History

16 October 2016

26 December 2016

Publication Date:
12 April 2017 (eFirst)

Abstract

Intermaxillary fixation (IMF) is a basic and fundamental principle in the management of patients with fractures of the maxillomandibular complex. There are several shortcomings related to the conventionally recommended tooth-mounted devices that are used to achieve IMF. To circumvent these, the use of bone-borne screws has been advocated. We present a series of maxillary fractures treated with IMF screws. Over a 12-month period, 15 cases of maxillary fracture were managed with open reduction and bone plate fixation. IMF screws were used to achieve IMF intraoperatively and for a short duration postoperatively. Eight cortical titanium screws were inserted transmucosally, two for each quadrant at the junction of the attached and mobile mucosa. Satisfactory occlusion was achieved in all the patients with few complications. IMF screw fixation was observed to be a safe and quick method for open reduction of maxillary fractures. Tooth-borne devices are associated with problems such as poor oral hygiene and periodontal health, extrusion of teeth, loss of tooth vitality, traumatic ulcers of buccal and labial mucosa, and needle stick injury to the operator. These procedures are also time consuming. The use of cortical bone screws is a quicker and safe alternative for achieving satisfactory IMF.