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Reduction techniques for mandibular fractures: Current means of obtaining occlusion:

IMF vs. hand-holding

Muhammad Azhar SheikhMSc. (Lond), FDSRCS (Eng), FFDRCS (Ire) FDS Oral Surg (UK) Prof: Oral and Maxillofacial Surgeon Islamic International Dental College, Isb

Trauma is the major cause of death in children and young

adults

Anatomic distribution

Desired Outcome

• Function

= Occlusion

• Aesthetics

Clinical Examination

Investigations

IMF techniques

Leonard buttons

Intra Oral Cortical Bone screws

Intra oral cortical bone screws

Rapid IMPF (Anchorage ties and Power Chain)

Rapid IMF

Rapid IMF (Anchorage Ties)

• Rapid – save about 40% time compare to eyelet IMF

• More tooth related complications like crown dislodgement

Lag Screw – IMF?

Hand held technique• Quick - half time compare to IMF • No gadgetry of IMF• No risk of wire injury• Cheap • Short anaesthesia & stay• Less complications (Systemic & Local)

• Similar outcome of occlusion

Hand held technique• Operator sensitive

• Experience & Skill required

• Competent assistant

• Relatively early Fracture

Summery – ORIF mandible • Most cases can be done with hand

held technique with its advantages

• IMF while plating is necessary in complicated cases

• No compromise on occlusion