(Centre for Translational Medicine, Semmelweis University)
(Funding was provided by the Department of Oro-Maxillofacial Surgery and Stomatology,
Semmelweis University)
Subjects:
Dentistry, oral surgery and medicine
Jaw fractures are prevalent facial injuries. Choosing the optimal intermaxillary/maxillomandibular
fixation(IMF/MMF) technique is crucial for a successful conservative and surgical
treatment, to achieve perfect occlusion.This network meta-analysis aimed to identify
the most time-efficient and safe technique for IMF by comparing currently used techniques.
A systematic search was performed in four databases, where 20,249 studies were identified;
after the selection process 29 were included in the synthesis. Application time of
IMF screws(IMFS)(MD -47,95% CI -62 to-33) and Hybrid Maxillomandibular Fixation(HMMF)(MD
-33, 95% CI -48 to -19), and removal of IMFS (MD -16, 95% CI -23 to -8) were significantly
shorter than Erich Arch Bar(EAB). EAB causes significantly fewer iatrogenic injuries
than IMFS(OR: 0.30, 95% CI 0.09-0.93) or HMMF(OR 0.20, 95% CI 0.05-0.76). Both IMFS
and HMMF were associated with a significantly lower risk of glove perforation and
needlestick injury than EAB: OR 0.05(95% CI 0.02-0.12) and 0.08 (95% CI 0.03-0.23),
respectively. In conclusion, IMF screws and HMMF are more effective than EAB in terms
of application and removal time, oral hygiene, and patient acceptance. They also offer
greater safety in terms of gloves and needlestick injuries, although there is a higher
risk of iatrogenic injuries and hardware loosening.
