• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.35 no.1
• /
• pp.51-54
• /
• 2013

Purpose: The purpose of this study is to evaluate the difference between open reduction and internal fixation (ORIF) and intermaxillary fixation (IMF) of mandibular fractures. Methods: A total of one hundred twenty-seven patients who were treated for mandibular fractures at Chosun University Dental Hospital, from January 2008 to December 2010, and analyzed their prognoses based on the use of IMF at the time of fracture reduction. The patients were divided into two groups; the manual reduction group without IMF and IMF group. Results: After reduction of the mandibular fracture, good results were obtained with majority patients. Nonetheless, seven patients (13.0%) in manual reduction method without arch bars or IMF, developed complications after surgery. Three patients underwent IMF due to occlusal instability after surgery, while one patient underwent re-operation. Thus, a significant difference was not observed between the IMF and manual reduction groups. Conclusion: Manual reduction and IMF at mandibular simple fracture could produce good results. In case of mandibular simple fracture, it was recommended with only manual reduction without IMF or IMF during a short period.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.28 no.5
• /
• pp.477-482
• /
• 2006

The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.29 no.6
• /
• pp.513-519
• /
• 2007

Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

• Journal of Korean Dental Science
• /
• v.2 no.2
• /
• pp.24-30
• /
• 2009

Two component orthodontic C-implants have been introduced as intermaxillary fixation (IMF) screws in cases of periodontal problems with bone loss, severely damaged teeth, or short roots. This retrospective research sought to investigate the complications and risk factors associated with the failure of two-part C-implants for IMF cases and to show the possible indications compared to one-component mini-implants. The study sample consisted of 46 randomly selected patients who had a total of 203 implants. Pearson chi-square tests of independence were used to test for associations among categorical variables. At least 19 of the total 203 implants failed (9.3%). There was no significant difference in implant failure due to gender, oral hygiene, and placement, although a significant difference due to soft tissue characteristics and root contact was observed. The two-component design of the mini-implant is reliable for difficult IMF cases. Note, however, that the factors influencing implant failure were found to be age, root damage, and condition of soft tissues.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.4
• /
• pp.372-380
• /
• 2005

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.

• Archives of Craniofacial Surgery
• /
• v.23 no.1
• /
• pp.23-28
• /
• 2022

Background: Intermaxillary fixation (IMF) is a technique that allows for the reduction and stabilization of mandibular fractures. Several methods of IMF, such as self-tapping screws or arch bars, have been developed. This study aimed to validate the usefulness of IMF with a self-tapping screw compared to IMF with arch bars with focus on the patients' perspective. Methods: We retrospectively reviewed the medical records of all patients who were treated for mandibular fractures at our hospital between August 2014 and February 2021. A total of 57 patients were enrolled in this study. Thirteen patients were excluded from the analysis: three patients were lost to follow-up, and 10 patients did not undergo IMF. Finally, 44 patients were analyzed, of which 31 belonged to the arch bar group, and 13 belonged to the screw group. Patient discomfort and pain during IMF application and removal were analyzed using a patient self-assessment questionnaire. The surgeon also assessed oral hygiene, IMF stability, and occlusion. Results: We applied IMF to 34 men (77%) and 10 women (23%). The mean age of the patients was 37.3 years. The most common fracture site was the angle (30%), followed by the parasymphysis (25%), the body (23%), the condyle (11%), and the ramus (11%). Patient discomfort and oral hygiene were statistically favorable in the screw group. The IMF application time was statistically shorter in the screw group (p< 0.001). IMF stability was not statistically different between the two groups. The pain score during IMF removal was lower in the screw group (p< 0.001). Conclusion: Compared to arch bars, IMF screws provide more comfort during the IMF period, help maintain favorable oral hygiene, and have a shorter application time. From the patient's perspective, IMF screws are an excellent alternative to conventional arch bars when applicable.

• The korean journal of orthodontics
• /
• v.45 no.1
• /
• pp.3-12
• /
• 2015

Objective: We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. Methods: All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery ($T_0$), (b) 3 months after surgery ($T_1$), and (c) 6 months after surgery ($T_2$). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t -test procedure was used to compare the two groups. Results: After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from $T_0$ to $T_1$, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). Conclusions: This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.

• The korean journal of orthodontics
• /
• v.29 no.4 s.75
• /
• pp.457-466
• /
• 1999

It has been reported that skeletal relapse and dental change after mandibular setback do occur not only after intermaxillary fixation(IMF) removal but also during IMF The side effects of skeletal relapse during IMF have clinical importance because they can cause many Postoperative orthodontic Problems. Generally, the Prevention of solid union between segments, compensatory tooth movement, anterior openbite, etc. have been cited as the side effects of jaw displacement. The purpose of this study was to evaluate the skeletal relapse and dental change during IMF. The material consisted of 28 patients who were treated by BSSRO(bilateral sagittal split ramus osteotomy), wire osteosynthesis, IMF for correction of mandibular prognathism. Through cephalometric analysis, the amount and direction of surgical movement, skeletal relapse and dental change during IMF were measured. The correlation between surgical movement and skeletal relapse, between skeletal relapse and dental changes were evaluated. The following conclusions were obtained; 1. Distal segment was repositioned backward and upward, proximal segment showed clockwise rotation during surgery. 2. During ]m, anterior portion of distal segment was displaced backward and posterior portion was displaced upward. Proximal segment was displaced upward with forward movement of p-Go(gonion of proximal segment). Backward surgical movement of p-GO was significantly correlated with forward displacement of p-Go. 3. Overjet and overbite were not changed during IMF. The compensatory tooth movements during IMF were characterized by retroclination of upper incisors md retroclination, extrusion of lower incisors. These compensatory tooth movements had statistically significant correlation with upward displacement of d-Go (gonion of distal segment).

• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.51-54
• /
• 2008

Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.11 no.1
• /
• pp.12-20
• /
• 1989

This is a retrospective study on 452 patients with maxillofacial bone fracture. The patients were treated at the Dept. of Oral and Maxillofacial Surgery, WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30, 1988. The results were as follows. 1. The facial bone fractures occured most frequently in the twenties (35.3%)and male were predominant(75%) than female. 2. The most frequent etiologic factor was traffic accident. 3. The most common location of facial bone fracture was mandible(57%). Zygomatic bone & arch(39.9%) were most common on middle 1/3 of the face and symphysis(37.1%) were most common on the mandible. 4. The time from injury to treatment was variable from under the 1 week (65%) to over the 1 week(35%). In most case of the patients were treated beyond the 3 days(51.5%). 5. The relationship of intermaxillary fixation period and treatment method was an intimate relationship. The IMF period was reduced by the use of plate and screw osteosynthesis. 6. The weight loss was proportioned to intermaxillary fixation period.