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Patients with jaw fractures requires placement of Erich arch bar for immobilization of the fractured jaw. However, the usage of Erich arch bar is associated with an increased in the incidence of mucosal trauma and plaque accumulation. Conventionally, the ends of the wires has always been placed apical to the teeth.
This study aims to determine if a change in the placement of the wire by directing it to the occlusal direction will reduce the incidence of mucosal trauma, plaque accumulation and if the stability of the Erich arch bar will be affected by this intervention.
The patients' teeth will be divided into left and right side and randomized into control side (wires end apically) and interventional side (wires end occlusally)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Occlusal ending of wires | Experimental | The wires will be bent occlusally for the interventional side |
|
| Apical ending of wires | No Intervention | The wires will be bent apically for the control side. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ending of the wires on Erich arch bar in the occlusal direction | Device | The wires of the Erich arch bar will be placed on the occlusal direction |
|
| Measure | Description | Time Frame |
|---|---|---|
| Are there any differences between occlusally and apically bent groups in terms of mucosal trauma? | Any mucosal injuries (Indentations, Entrapment, ulcerations) during follow up will be recorded as scored as '1'. | Assessed on the second week |
| Are there any differences between occlusally and apically bent groups in terms of mucosal trauma? | Any mucosal injuries (Indentations, Entrapment, ulcerations) during follow up will be recorded as scored as '1'. | Assessed on the fourth week |
| Measure | Description | Time Frame |
|---|---|---|
| Are there any differences between occlusally and apically bent groups in terms of Turesky-Gilmore-Glickman plaque score? | Assessment of the plaque score using Turesky-Gilmore-Glickman plaque score. There are 6 scores for this plaque index, ranging from score '0' to '5'. Score '0' means that no plaque is seen, '1' when separate flecks of plaque at the cervical margin of the tooth, '2' when a thin continuous band of plaque at the cervical margin of the tooth, '3' when a band of plaque thicker than 1mm but less than 1/3rd of the tooth surface. '4' when plaque covers at least 1/3rd but less than 2/3rd of the crown and '5' when plaque is covering 2/3rd or more of the crown of the tooth. The teeth involved in the scoring in this study are buccal surfaces of the 1st molars, premolars, canines and incisors. Since the lingual/palatal surfaces are not accessible as the teeth are wired up, it will not be assessed Score '0' is the best while score of '5' is the worst. This assessment is done on the fourth week after removal of the arch bar and staining of the teeth with a disclosing solution. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| NG Kar Tsyeng, BDS | Contact | 0165216351 | kartsyeng86@Hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universiti Sains Malaysia | Kota Bharu | Kelantan | 16150 | Malaysia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16270942 | Background | Adeyemo WL, Ladeinde AL, Ogunlewe MO, James O. Trends and characteristics of oral and maxillofacial injuries in Nigeria: a review of the literature. Head Face Med. 2005 Oct 4;1:7. doi: 10.1186/1746-160X-1-7. | |
| 27563602 | Background | 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 Jan-Jun;6(1):25-30. doi: 10.4103/2231-0746.186129. |
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| ID | Term |
|---|---|
| D008446 | Maxillofacial Injuries |
| ID | Term |
|---|---|
| D005151 | Facial Injuries |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D009422 | Nervous System Diseases |
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this is a split mouth study. Participants teeth will be divided into left or right side and randomised into either control or intervention side.
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Participants are blinded
| Assessed on the fourth week. |
| Are there any differences between occlusally and apically bent groups in terms of stability of the arch bar? | The operator will assess all circumferential wires on the second week. Any loose wires will be scored as '1' and '0' if the wires are firm. The loose wires will be retightened. | Assessed on the second week |
| Are there any differences between occlusally and apically bent groups in terms of stability of the arch bar? | The operator will assess all circumferential wires on the fourth week. Any loose wires will be scored as '1' and '0' if the wires are firm. The loose wires will be retightened. | Assessed on the fourth week |
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| 22110797 | Background | Gilardino MS, Chen E, Bartlett SP. Choice of internal rigid fixation materials in the treatment of facial fractures. Craniomaxillofac Trauma Reconstr. 2009 Mar;2(1):49-60. doi: 10.1055/s-0029-1202591. No abstract available. |
| 25284337 | Background | Haggard P, de Boer L. Oral somatosensory awareness. Neurosci Biobehav Rev. 2014 Nov;47:469-84. doi: 10.1016/j.neubiorev.2014.09.015. Epub 2014 Oct 2. |
| 35265493 | Background | Hamid ST, Bede SY. The Use of Screw Retained Hybrid Arch Bar for Maxillomandibular Fixation in the Treatment of Mandibular Fractures: A Comparative Study. Ann Maxillofac Surg. 2021 Jul-Dec;11(2):247-252. doi: 10.4103/ams.ams_35_21. Epub 2022 Feb 1. |
| 34315565 | Background | Jain A, Taneja S, Rai A. What is a better modality of maxillomandibular fixation: bone-supported arch bars or Erich arch bars? A systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2021 Oct;59(8):858-866. doi: 10.1016/j.bjoms.2021.01.004. Epub 2021 Jan 18. |
| 26546844 | Background | Kirk D, Whitney J, Shafer D, Song L. Tight Placement of Erich Arch Bar While Avoiding Wire Fatigue Failure. J Oral Maxillofac Surg. 2016 Mar;74(3):562-8. doi: 10.1016/j.joms.2015.10.008. Epub 2015 Oct 19. |
| 22550460 | Background | Koshy JC, Feldman EM, Chike-Obi CJ, Bullocks JM. Pearls of mandibular trauma management. Semin Plast Surg. 2010 Nov;24(4):357-74. doi: 10.1055/s-0030-1269765. |
| 10967765 | Background | Loe H. Oral hygiene in the prevention of caries and periodontal disease. Int Dent J. 2000 Jun;50(3):129-39. doi: 10.1111/j.1875-595x.2000.tb00553.x. |
| 25511963 | Background | Tracy K, Gutta R. Are embrasure wires better than arch bars for intermaxillary fixation? J Oral Maxillofac Surg. 2015 Jan;73(1):117-22. doi: 10.1016/j.joms.2014.08.020. Epub 2014 Aug 27. |
| 16568382 | Background | Uhthoff HK, Poitras P, Backman DS. Internal plate fixation of fractures: short history and recent developments. J Orthop Sci. 2006 Mar;11(2):118-26. doi: 10.1007/s00776-005-0984-7. |
| 29198481 | Background | Vadepally AK, Sinha R. Is it better to bend wires occlusally or apically during placement of arch bars for intermaxillary fixation? Br J Oral Maxillofac Surg. 2018 Jan;56(1):67-69. doi: 10.1016/j.bjoms.2017.11.006. Epub 2017 Dec 6. |
| 25911121 | Background | van den Bergh B, Blankestijn J, van der Ploeg T, Tuinzing DB, Forouzanfar T. Conservative treatment of a mandibular condyle fracture: Comparing intermaxillary fixation with screws or arch bar. A randomised clinical trial. J Craniomaxillofac Surg. 2015 Jun;43(5):671-6. doi: 10.1016/j.jcms.2015.03.010. Epub 2015 Mar 27. |
| 29963429 | Background | Kaura S, Kaur P, Bahl R, Bansal S, Sangha P. Retrospective Study of Facial Fractures. Ann Maxillofac Surg. 2018 Jan-Jun;8(1):78-82. doi: 10.4103/ams.ams_73_17. |
| 28223831 | Background | Saperi BS, Ramli R, Ahmed Z, Muhd Nur A, Ibrahim MI, Rashdi MF, Nordin R, Rahman NA, Yusoff A, Nazimi AJ, Abdul Rahman R, Abdul Razak N, Mohamed N. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study. Clinicoecon Outcomes Res. 2017 Feb 7;9:107-113. doi: 10.2147/CEOR.S119910. eCollection 2017. |
| 31371884 | Background | Rothe TM, Kumar P, Shah N, Shah R, Mahajan A, Kumar A. Comparative Evaluation of Efficacy of Conventional Arch Bar, Intermaxillary Fixation Screws, and Modified Arch Bar for Intermaxillary Fixation. J Maxillofac Oral Surg. 2019 Sep;18(3):412-418. doi: 10.1007/s12663-018-1110-7. Epub 2018 Apr 19. |
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| 31310733 | Background | Pedemonte C, Valenzuela K, Gonzalez LE, Vargas I, Noguera A. Types of Intermaxillary Fixation and Their Interaction With Palatine Fracture Reduction. J Oral Maxillofac Surg. 2019 Oct;77(10):2083.e1-2083.e8. doi: 10.1016/j.joms.2019.06.006. Epub 2019 Jun 21. |
| D014947 |
| Wounds and Injuries |