Treatment Outcomes for Isolated Maxillary Complex Fractures with Maxillomandibular Screws

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.