Intermaxillary fixation (IMF) Screws in minimally displaced mandibular fractures: A case control study

Abstract

Context: Numerous methods have been used for obtaining intermaxillary fixation (IMF) in the treatment of mandibular fractures. Conventional methods such as arch bars and eyelet wires have been the most common methods for achieving IMF, but they have their own disadvantages. During the last two decades, IMF using intraoral, self-tapping IMF screws have been introduced for the treatment of minimally displaced fractures of the mandible. The present case control study evaluated the efficacy and associated complications of self-tapping IMF screws in the treatment of minimally displaced mandibular fractures. Materials and Methods: A total of twenty patients of minimally displaced mandibular fractures were divided into two groups and were treated with open and closed reduction methods using self-tapping IMF screws to evaluate the efficacy of IMF screws and associated complications. Results: The most common complications encountered were pain and edema in almost all patients. In Group I treated with open reduction, damage to the roots of teeth occurred in two patients, which later became nonvital after 6 weeks, while in Group II treated with closed reduction, two patients were seen with tissue overgrowth and screw loosening. In one case, postoperative malocclusion was also observed in Group I. Conclusion: Use of self-tapping IMF screws for IMF is a valid alternative to conventional methods in the treatment of minimally displaced mandibular fractures. Iatrogenic injury to roots of the teeth is the most important complication of the IMF screws but that can be minimized and/or overcome by a careful evaluation and treatment planning of the cases.