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Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial

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Abstract

Objective

This randomized clinical trial aimed to compare the efficacy of Erich arch bars (EAB) and intermaxillary fixation (IMF) screws in reducing mandibular fractures during open reduction and internal fixation (ORIF).

Methods

A total of 28 patients with mandibular fractures were randomly allocated to either the EAB group or the IMF screws group. The study evaluated various parameters including occlusal stability, complications, duration of application, oral hygiene status, quality of life, and patient characteristics.

Results

The study found no significant differences in occlusal stability between the EAB and IMF screw groups. However, the application and removal times were longer for EAB compared to IMF screws. The EAB group showed a higher presence of biofilm on teeth, indicating poorer oral hygiene status compared to the IMF screws group. In terms of quality of life, patients in the EAB group reported worse results in the “handicap” domain at the 15th postoperative day. No significant differences were observed in other quality-of-life parameters. Patient characteristics were well distributed between the two groups, enhancing the reliability of the results.

Conclusion

Both EAB and IMF screws demonstrated comparable occlusal stability for minimally displaced mandibular fractures. However, IMF screws offered advantages such as shorter application and removal times, better oral hygiene maintenance, and potentially improved quality of life in the “handicap” domain. Further studies with larger sample sizes are necessary to validate these findings and explore the stability of IMF methods in cases requiring postoperative malocclusion correction or prolonged IMF.

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Data Availability

Raw data were generated at Universidade Federa dos Vales do Jequitinhonha e Mucuri. Derived data supporting the findings of this study are available from the corresponding author [IAF] on request.

References

  1. Jain A, Taneja S, Rai A (2021) What is a better modality of maxillomandibular fixation: bone-supported arch bars or Erich arch bars? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 59:858–866

    Article  PubMed  Google Scholar 

  2. Nandini GD, Balakrishna R, Rao J (2011) Self tapping screws v/s Erich arch bar for inter maxillary fixation: a comparative clinical study in the treatment of mandibular fractures. J Maxillofac Oral Surg 10:127–131

    Article  PubMed  PubMed Central  Google Scholar 

  3. Falci SG, Douglas-de-Oliveira DW, Stella PE, Santos CR (2015) Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review. Med Oral Patol Oral Cir Bucal 20:e494-499

    Article  PubMed  PubMed Central  Google Scholar 

  4. Fernandes IA, Lopes ABS, Fonseca PG, da Silva TA, Rodrigues AB, Galvão EL et al (2021) Comparison between Erich arch bars and intermaxillary screws in maxillofacial fractures involving the dental occlusion: a meta-analysis. Int J Oral Maxillofac Surg 50:83–95

    Article  PubMed  Google Scholar 

  5. Qureshi AA, Reddy UK, Warad NM, Badal S, Jamadar AA, Qurishi N (2016) Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: a comparative study and review of literature. Ann Maxillofac Surg 6:25–30

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tepass A, Rolauffs B, Weise K, Bahrs SD, Dietz K, Bahrs C (2013) Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970–2009. Patient Saf Surg 7:34

    Article  PubMed  PubMed Central  Google Scholar 

  7. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ et al (2010) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340:c869

    Article  PubMed  PubMed Central  Google Scholar 

  8. Costa MD, Froes Junior GRT, Santos CN (2012) Evaluation of occlusal factors in patients with temporomandibular joint disorder. Dental Press J Orthod 17(6):61–68

  9. Alpert B, Antonyshyn O, Assael LA, Audigé L, Bentley R, RM Bos R et al (2012) Principles of internal fixation of the craniomaxillofacial skeleton trauma and orthognatic surgery. In: Ehrenfeld M, Manson PN, Prein J, AO Foundation. AO Foundation; Georg Thieme Verlag, Davos, Switzerland, Stuttgart

  10. Gibbons AJ, Hodder SC (2003) A self-drilling intermaxillary fixation screw. Br J Oral Maxillofac Surg 41:48–49

    Article  PubMed  Google Scholar 

  11. Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235

    PubMed  Google Scholar 

  12. Sekar KSV, Natarajan PM, Kapasi AY (2017) Comparison of arch bar, eyelets and transmucosal screws for maxillo mandibular fixation in jaw fratcure. Biomed Pharmacol J 10:497–508

    Article  Google Scholar 

  13. Rai A, Datarkar A, Borle RM (2011) Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study. J Oral Maxillofac Surg 69:3015–3018

    Article  PubMed  Google Scholar 

  14. Barodiya A, Thukral R, Agrawal SM, Chouhan AS, Singh S, Loksh Y (2017) Self-tapping intermaxillary fixation screw: an alternative to arch bar. J Contemp Dent Pract 18:147–151

    Article  PubMed  Google Scholar 

  15. Vatsa P, Siddaraju A (2018) A comparative clinical study on self-drilling screws and Erich arch bars in mandibular fractures. International Journal of Applied Dental Sciences 4:212–217

    Google Scholar 

  16. Rothe TM, Kumar P, Shah N, Shah R, Mahajan A, Kumar A (2019) Comparative evaluation of efficacy of conventional arch bar, intermaxillary fixation screws, and modified arch bar for intermaxillary fixation. J Maxillofac Oral Surg 18:412–418

    Article  PubMed  Google Scholar 

  17. Vartanian AJ, Alvi A (2000) Bone-screw mandible fixation: an intraoperative alternative to arch bars. Otolaryngol Head Neck Surg 123:718–721

    Article  PubMed  Google Scholar 

  18. Choi JW, Kim HB, Jeong WS, Kim SC, Koh KS (2019) Comparison between intermaxillary fixation with screws and an arch bar for mandibular fracture. J Craniofac Surg 30:1787–1789

    Article  PubMed  Google Scholar 

  19. Gordon KF, Reed JM, Anand VK (1995) Results of intraoral cortical bone screw fixation technique for mandibular fractures. Otolaryngol Head Neck Surg 113:248–252

    Article  PubMed  Google Scholar 

  20. Balihallimath L, Jain R, Mehrotra U, Rangnekar N (2018) To compare the efficiency of maxillomandibular fixation screws over Erich arch bar in achieving intermaxillary fixation in maxillofacial trauma: a clinical study. J Int Clin Dent Res Organ 10(1):27–31

  21. Pathak P, Thomas S, Bhargava D, Beena S (2019) A prospective comparative clinical study on modified screw retained arch bar (SRAB) and conventional Erich’s arch bar (CEAB). Oral Maxillofac Surg 23:285–289

    Article  PubMed  Google Scholar 

  22. Pigadas N, Whitley SP, Roberts SA, McAlister K, Ameerally P, Avery CM (2008) A randomized controlled trial on cross-infection control in maxillofacial trauma surgery: a comparison of intermaxillary fixation techniques. Int J Oral Maxillofac Surg 37:716–722

    Article  PubMed  Google Scholar 

  23. Hassan SFS, Kapoor M, Shah A (2018) Comparative evaluation of modified Erich’s arch bar, conventional Erich’s arch bar and intermaxillary fixation screws in maxillo-mandibular fixation: a prospective clinical study. Int J Med Res Prof 4:41–45

    Google Scholar 

  24. Rothe TM, Kumar P, Shah N, Shah R, Kumar A, Das D (2018) Evaluation of efficacy of intermaxillary fixation screws versus modified arch bar for intermaxillary fixation. Natl J Maxillofac Surg 9:134–139

    Article  PubMed  PubMed Central  Google Scholar 

  25. van den Bergh B, de Mol van Otterloo JJ, van der Ploeg T, Tuinzing DB, Forouzanfar T (2015) IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects. J Craniomaxillofac Surg 43:1004–1009

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dentistry, Section of Oral and Maxillofacial Surgery, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Rua da Glória, 187, Centro – Oral Surgery Clinic, Diamantina, Minas Gerais, Brazil

    Ighor Andrade Fernandes

  2. Department of Oral and Maxillofacial Surgery, Thamar University, Dhamar, Yemen

    Essam Ahmed Al-Moraissi

  3. Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil

    Endi Lanza Galvão

  4. Department of Dentistry, Oral and Maxillofacial Section, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil

    Saulo Gabriel Moreira Falci

Authors
  1. Ighor Andrade Fernandes
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  2. Essam Ahmed Al-Moraissi
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  3. Endi Lanza Galvão
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  4. Saulo Gabriel Moreira Falci
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all authors contributed in this study equally

Corresponding author

Correspondence to Ighor Andrade Fernandes.

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Fernandes, I.A., Al-Moraissi, E.A., Galvão, E.L. et al. Erich arch bars vs intermaxillary fixation screws for mandibular fracture reduction during ORIF: a randomized clinical trial. Clin Oral Invest 27, 6063–6071 (2023). https://doi.org/10.1007/s00784-023-05220-x

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  • DOI: https://doi.org/10.1007/s00784-023-05220-x

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