Use of specialized bone screws for intermaxillary fixation

Fixation of the injured mandible to the maxilla is a proven method of stabi lizing mandibular fractures and ensuring proper occlusion. The authors repo rt their results with new specialized intraoral bone screws (IMF Screw Syst em; Howmedica Leibinger, Inc., Carrollton, TX) that are designed for the pu rpose of achieving intermaxillary fixation (IMF). Nineteen patients were pl aced into rigid IMF using IMF screws alone. Indications were nondisplaced m andibular fractures; symphyseal, body, and angle fractures; midfacial fract ures requiring temporary IMF; and edentulous patients with any of these fra cture types and an adequate prosthesis. All procedures were performed with the patient under general anesthesia. The authors found that the operative time was markedly shorter than with standard IMF techniques, patient satisf action was high, and there were no infections related to the screws. All 19 patients remained in stable, accurate occlusion and had adequate healing. One patient continues to have paraesthesias In the mental nerve distributio n after screw removal. Although there is the potential for tooth and nerve injury when screws are placed improperly, the IMF Screw System seems to be a safe and reliable method of achieving secure mandibular fixation.