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JOURNAL OF MAXILLOFACIAL TRAUMA
Rivista di Traumatologia Maxillofacciale
Official Journal of the International Society of Maxillofacial Trauma
Journal of Maxillofacial Trauma 2013 December;2(3):55-60
Comparison of intermaxillary fixation versus manual method of reduction in the management of mandibular fractures
Sharma A. 1, Kumar B. P. R. 2, Kenkere D. 3, Kumar Rai K. 2, Preet Singh H. 4
1 Department of Oral and Maxillofacial Surgery, SGT Dental College Hospital and Research Institute, Gurgaon, Haryana, India;
2 Department of Oral and Maxillofacial Surgery, Bapuji Dental College Hospital and Research Institute, Davangere, India;
3 Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bangalore, Karnataka, India;
4 Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
Aim: The mandible is a prominent bone of the face, therefore it is more prone to fractures. The realignment of the fractured mandible in order to establish a normal occlusion has always intrigued the inquisitiveness of the oral and maxillofacial surgeon. Several techniques have been described from past many times to achieve favorable outcome. Aim of the present study was to compare intermaxillary fixation (IMF) with the manual method of fracture reduction prior to fixation and thereby to evaluate postoperative occlusal outcome, radiographic alignment and to assess the advantages and disadvantages of the individual methods.
Methods: Thirty three patients with mandibular fractures were treated by open reduction internal fixation (ORIF) by dividing them into two groups. Group 1 consisted of 17 patients treated by manual reduction. Group 2 consisted of 16 patients treated by IMF reduction. The patients were followed up for six weeks to assess their occlusion; postoperative radiographic alignment; need for use of postoperative intermaxillary elastic traction, IMF, occlusal adjustment, or second operation required to correct a malocclusion; patients subjective assessment of occlusion at discharge; and complications of treatment. Results obtained were statistically analysed using Chi square test, Student’s t-test and Fischer’s exact test.
Results: The results show that the traditional method of reduction with IMF does not provide any additional benefit over the technically sensitive manual reduction prior to rigid internal fixation.
Conclusion: Under ideal conditions, the traditional method of reduction with IMF does not provide any additional benefit over the technically sensitive manual reduction prior to rigid internal fixation. A careful selection of the cases should be done prior to using either of the two methods of reduction. However, a careful selection of the cases should be done prior to using either of the two methods of reduction.