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Comparison Between Intermaxillary Fixation With Screws and an Arch Bar for Mandibular Fracture

Choi, Jong-Woo MD, PhD; Kim, Hyung Bae MD; Jeong, Woo Shik MD, PhD; Kim, Sung Chan MD, PhD; Koh, Kyung S. MD, PhD

doi: 10.1097/SCS.0000000000005488
Clinical Study: PDF Only

Purpose: Intermaxillary fixation (IMF) using the arch bar has been the standard technique for a long time in the management of mandibular fracture. But because of several complications, intermaxillary fixation with screws has been introduced and adopted to use. This investigation compared the outcomes and complications between the traditional IMF and modified intermaxillary fixation with screws techniques in terms of the malocclusion, surgical time, root injury, and screw or arch bar failure.

Methods: This retrospective review included 66 patients who underwent reconstruction of mandibular fractures that uses traditional arch bar or IMF screws as IMF. Preoperative and postoperative facial bone computed tomography, panoramic x-ray were used to evaluate the patients. The complaints and complications were recorded in electric medical record based on patients’ consultation during follow-up.

Results: The total complication rate was no higher using anchoring screw as an IMF than using arch bar fixation as an IMF. Mean surgical time was significantly shorter in the anchoring screw group than arch bar fixation (111 versus 157 min; P < .05). After compensation of the number of fracture sites, there was a significant difference in operation time (linear regression model, P = .009).

Conclusion: This investigation revealed that the IMF using IMF screw systems could be a good alternative for the management of mandibular fracture. It could minimize the whole operation time with the similar complication ratio.

Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Jong-Woo Choi, MD, PhD, Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea; E-mail:

Received 4 March, 2018

Accepted 14 February, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.