Idashkina N. Improvement of treatment of mandibular fractures by a new wire anchor splint

Dissertation on the question of increase of treatment rates of mandibular fractures by the guided reposition of mandibular fragments by the wire anchor splint of new construction. After the analysis of case histories between 1997 and 2006 there were revealed the certain clinical disadvantages of treatment of mandibular fractures at the use of wire or standard band splints. Own clinical and roentgenologic study presented 30 patients with the mandibular fractures in the area of dentition, treated with the use of wire or standard band splints. Results which were got led to absence of precise reposition of bones fragments and malocclusion on the side of one of the fragments, as a result of rigid fixation by a splint. Own clinical test of new wire anchor splint with a modifying spring element for treatment of mandibular fractures is presented. We make mandibular wire anchor splint of a thin orthodontic wire with forming of a modifying spring element in the form of loop, which it should be placed at the level of fracture line. The anchor splint, which we offered enables to carry out the guided reposition of bone fragments using the elastic tractions. The splint is used in presence of not less than three teeth on each fragment. A splint on the maxilla is made without a modifying spring element. After fixation of splints, over a period of 1-2 days we succeeded to disengage bone fragments by the instrumentality of intermaxillary elastics, then to set the complete contact with teeth cuspes of tooth-antagonists over the whole occlusion. On the final stage direction of intermaxillary elasticsis is changed into upright stabilizing position. This position is retained to a full consolidation of a fracture. We are made an analysis of cases 33 patients with the fractures of mandible, treatment of which was carried out the method of intermaxillary fixation with the use of new wire anchor splint with a modifying spring element. The results of functional researches and roentgenologic study in a basic group were compared to such results in the control group 30 patients with the fractures of mandible, treatment of which was carried out the method of intermaxillary fixation with the use of the wire anchor splint of S.S. Tigershtedt or standard band splints. The absence of reliable difference of functional indexes is ascertaind for the patients in basic and control groups. The roentgenologic study and occlusiography showed that the use of modifying spring element, allowed to carry more effective correction of position of mandibular fragments, efficacy of reconstruction of dental occlusion and full reposition in all 33 patients, treated by this method. The main results of the research can be used to increase the effectiveness of treatment of mandibular fractures in the maxillo-faciale surgical departments.