Comparison of intraoperative and postoperative outcomes of arch bar splinting versus wire composite splinting in the management of patients with dentoalveolar fractures.

Abstract

Introduction: Dentoalveolar fracture involves injuries to the dentition, periodontium and alveolar bone, which may occur individually or concurrently. The International Association of Dental Traumatology (IADT) guidelines recommend the use of flexible splints for a shorter duration in cases of dentoalveolar trauma.

Objectives: To compare and evaluate the intraoperative and postoperative outcome of the arch bar splinting and wire composite splinting in the management of Clark's Class II dentoalveolar fractures.

Materials and methods: Patients were randomized by Envelope method of randomization. Equal number of patients were randomly allocated to two groups, irrespective of age, gender, type, and severity of fractures. The study population was divided equally into two groups. Group A- Patients in whom dentoalveolar fractures were managed by arch bar splinting. Group B- Patients in whom dentoalveolar fractures were managed by wire composite splinting. All patients were managed by a single maxillofacial surgeon.

Results: The mean time for splinting in group B was 7.52±0.76 min. No glove perforation or intraoperative blood loss was observed in group B. No soft tissue injury in terms of mucosal ulcerations and gingival trauma was noted in patients of group B. The pain intensity recorded was mild on the VAS scale on postoperative day 1. This resulted in better patient comfort/acceptance of the treatment in patients of group B. Oral hygiene status evaluated by using Modified Turesky Gilmore Plaque Index was significantly better in group b as compared to group A(p=0.018).

Conclusion: Dentoalveolar fractures are mostly managed by closed treatment. The type and time of splinting depends on the type of injury and the amount of stabilization needed for the specific injury. The use of wire composite splint proved to be an ideal treatment option for Clark's Class II dentoalveolar fractures.