J Korean Assoc Oral Maxillofac Surg.  2023 Dec;49(6):332-338. 10.5125/jkaoms.2023.49.6.332.

Comparison of hybrid arch bar versus conventional arch bar for temporary maxillomandibular fixation during treatment of jaw fractures: a prospective comparative study

• Burman S
• Rao S
• Ankush A
• Uppal N

• KMID: 2550296
• DOI: http://doi.org/10.5125/jkaoms.2023.49.6.332

Abstract

Objectives
This study aimed to compare the effectiveness of a hybrid arch bar (hAB) with the conventional Erich arch bar (EAB) for the management of jaw fractures, focusing on their use for temporary fixation in patients undergoing open reduction and internal fixation (ORIF).
Materials and Methods
Patients presenting with maxillary and mandibular fractures at our institution were included in this prospective, comparative study. Placement time and ease of occlusal reproducibility were recorded intraoperatively for Group A (hAB patients) and Group B (EAB patients). The primary outcome was comparison of the postoperative stability of the two arch bars. Postoperative measurements also included mucosal overgrowth, screw loosening or wire retightening, and replacement rates. The data were tabulated and computed with a P<0.05 considered statistically significant.
Results
The study included 41 patients. A statistically significant difference was observed in postoperative stability scores (3) between Group A and Group B (85.0% vs 9.5%, P=0.001). The mean placement time in Group A (23.3 minutes) significantly differed from that in Group B (86.4 minutes) (P<0.001). The ease of intraoperative occlusion was not different between the two groups (P=0.413). Mucosal overgrowth was observed in 75.0% of patients (15 of 20) in Group A.
Conclusion
The hAB was superior to EAB in clinical efficiency, maxillomandibular fixation time reduction, stability, versatility, and safety. Despite temporary mucosal overgrowth, the benefits of hAB outweigh the disadvantages. The choice between hAB and EAB should be based on specific clinical requirements.

Keyword

Maxillomandibular fixation; Mandibular fractures; Maxillofacial injuries; Maxillofacial procedure; Jaw fixation technique

Figure

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  Fig. 1 A. Intraoperative image of hybrid arch bar showing bendable flanges. B. Mucosal overgrowth over screw head (75%-100% coverage) after 4 weeks of hybrid arch bar placement. C. Mucosal overgrowth over screw head (<50% coverage) after 4 weeks of hybrid arch bar placement.

Reference

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