Feasibility of using screw-acrylic bar technique for canine mandibular fracture fixation

Abstract

Bone plates and screws (BPS) have been used for mandibular fracture repair for decades. Although bone
healing can be achieved, complications such as damage of dental roots and the inferior alveolar nerve in the mandibular
canal have been reported. A screw-acrylic bar technique (SAB) was developed in this study as an approach to minimize
those complications. The objective of this study was to compare the percentage of dental root and mandibular canal
damage induced by inappropriate screw insertion using the SAB technique with that using BPS fixation. Fifteen
mesocephalic canine cadavers were used for this study. For each cadaver, bilateral transverse mandibular fractures
were created between the 4th premolars and 1st molars. Pre- operative planning by CT scanning was performed to
minimize the chance of inappropriate screw insertion. The fracture of the right mandible was stabilized using a
conventional BPS method while the contralateral ramus was stabilized with the SAB technique using the same number
of screws. Post-operative CT scanning was carried out for the evaluation damage to dental roots and mandibular canals.
Statistical analyses by paired t- test revealed a significantly lower percentage of dental root and mandibular canal
damage for the SAB stabilized mandibles when compared to those that underwent BPS fixation (P<0.05). In conclusion,
this novel SAB technique is a feasible alternative for the stabilization of mid-body mandibular fractures, and involves
a lower risk of dental root and mandibular canal damage.