A questionnaire survey on postoperative intermaxillary fixation in mandibular trauma: Is its use based on evidence?

Abstract

Context:This questionnaire survey was conducted to ascertain if the practice of the routine use of postoperative intermaxillary fixation (IMF) in mandibular trauma (of the dentate segments only) was based on evidence available in the literature.Settings and Design:This study was designed as a questionnaire survey that would be conducted among surgeons operating on mandibular fractures in the state of Gujarat.Materials and Methods:A typed questionnaire was sent to oral maxillofacial surgeons and plastic surgeons of Gujarat state for their feedback by post. Approval of the ethical committee of the university was obtained. All the feedback forms received back were included for this survey which included 25 oral and maxillofacial surgeons and 25 plastic surgeons.Results:Although majority of the surgeons use open reduction and internal fixation (ORIF), 25% of the surgeons still prefer using only IMF as the sole modality of treatment for the said group of mandibular fractures. According to our survey, the majority of surgeons use IMF routinely in the postoperative setting even after using ORIF. Occlusion seems to be the critical factor among 72% of surgeons in deciding on the use of IMF as an adjunct after ORIF. Seventy-eight percent of surgeons vary their period of IMF based on the site of fracture.Conclusion:The routine use of postoperative IMF in cases of mandibular fractures seems to find favor among surgeons despite lack of sound scientific evidence supporting its use. There is also no evidence to suggest that if IMF is not used, it would have deleterious effects on occlusion or otherwise.

Assessment of Changes in Paraclinical Indexes Due to Intermaxillary Fixation: A Prospective Clinical Study

“…Hence, the affected mouth and nasal breathing would create some deal of hypoxia which the body increases by increase in the Hb level, like when it's seen in heavy smokers and mountain climbers. [17] Thus we can conclude that the increase in Hb is a physiologic reaction due to its role in oxygenation and not the nutrition condition. Also in our study the lipid profile was evaluated in terms of total cholesterol (TC) level TG level, HDL, and LDL level.…”

Evaluation of changes in paraclinical indexes due to intermaxillary fixation

“…Hence, the affected mouth and nasal breathing would create some deal of hypoxia which the body increases the Hb level as a counteraction, like when it's seen in heavy smokers and mountain climbers. 32 We can conclude that the increase in Hb is a physiologic reaction due to its role in oxygenation and not the nutrition condition.…”

Effect of intermaxillary fixation on paraclinical indexes

“…Hence the affected nasal and mouth breathing would lead to some degree of hypoxia and the body raises the Hb levels as a response to this insult. This is also seen in smokers and mountaineers [32] . Therefore increase in Hb is a physiological reaction.…”