A COMPARATIVE STUDY OF THE MODIFIED SMART LOCK HYBRID ARCH BAR AND INTERMAXILLARY FIXATION SCREWS FOR MAXILLOMANDIBULAR FIXATION IN PATIENTS WITH MAXILLOFACIAL TRAUMA AT VIET DUC UNIVERSITY HOSPITAL
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Abstract
Background: Intermaxillary fixation is essential in maxillofacial trauma with occlusal disturbance. Erich/Tiguerstedt arch bars are stable but time-consuming. IMF screws are faster, although screw loosening, soft-tissue overgrowth and root contact may occur. The modified Smart Lock hybrid arch bar was designed to improve fixation stability.
Objective: To compare outcomes of the modified Smart Lock hybrid arch bar and IMF screws for intermaxillary fixation in maxillofacial trauma.
Subjects and methods: This prospective comparative descriptive study included 20 patients indicated for intermaxillary fixation: 10 treated with Smart Lock and 10 with IMF screws. Placement time, number of screws, root contact, postoperative pain, occlusion and complications were evaluated.
Results: Mean age was 26.7 ± 10.6 years; males accounted for 75.0%. Road traffic accidents accounted for 80.0%, and isolated mandibular fractures for 55.0%. Placement time was longer with Smart Lock than with IMF screws (24.5 ± 10.2 versus 11.8 ± 5.5 minutes). Root contact occurred in 20.0% versus 10.0%. Good occlusion was achieved in 10/10 and 9/10 patients, respectively.
Conclusion: Both methods were effective. IMF screws are faster and simpler, whereas Smart Lock offers firm fixation and may be suitable for complex fractures requiring stable postoperative occlusal control.
Keywords
Intermaxillary fixation, Smart Lock Hybrid, IMF screws, Erich arch bar, mandibular fracture, maxillofacial trauma
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References
2. Bộ Y tế. Quyết định số 2121/QĐ-BYT ngày 21/5/2020 về việc ban hành tài liệu “Hướng dẫn quy trình kỹ thuật chuyên ngành Răng Hàm Mặt”. Hà Nội: Bộ Y tế; 2020.
3. Qureshi AA, Reddy UK, Warad NM, Badal S, Jamadar AA, Qurishi N. Intermaxillary fixation screws versus Erich arch bars in mandibular fractures: a comparative study and review of literature. Ann Maxillofac Surg. 2016;6(1):25-30.
4. Chao AH, Hulsen J. Bone-supported arch bars are associated with comparable outcomes to Erich arch bars in the treatment of mandibular fractures with intermaxillary fixation. J Oral Maxillofac Surg. 2015;73(2):306-313.
5. Kendrick DE, Park CM, Fa JM, Barber JS, Indresano AT. Stryker SMARTLock hybrid maxillomandibular fixation system: clinical application, complications, and radiographic findings. Plast Reconstr Surg. 2016;137(1):142e-150e.
6. King BJ, Christensen BJ. Hybrid arch bars reduce placement time and glove perforations compared with Erich arch bars during the application of intermaxillary fixation: a randomized controlled trial. J Oral Maxillofac Surg. 2019;77(6):1228.e1-1228.e8.
7. Aslam-Pervez N, Fialkov J. A randomized prospective comparison of maxillomandibular fixation techniques: “SMARTLock” hybrid MMF versus MMF screws. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;130(6):640-644.
8. Nguyễn Quốc Trung, Nguyễn Hồng Hà, Đặng Triệu Hùng. Đặc điểm lâm sàng, phim cắt lớp vi tính của bệnh nhân gãy xương hàm dưới tại khoa Phẫu thuật Hàm mặt - Tạo hình - Thẩm mỹ, Bệnh viện Hữu nghị Việt Đức năm 2018–2023. Tạp chí Y học Việt Nam. 2023;531(2):6-10.
9. Vũ Trung Trực, Nguyễn Thái An. Đặc điểm gãy xương hàm dưới tại Bệnh viện Hữu nghị Việt Đức 6 tháng cuối năm 2023. Tạp chí Y học Việt Nam. 2025;551(1).
10. Alam MT, Mittal A, Jassar Klarie S, Sharma S, Roy B, Gupta A. A comparative study of smart lock hybrid arch bar with IMF (intermaxillary fixation) screws in maxillomandibular fixation. Natl J Maxillofac Surg. 2025;16(3):563-567.