Clinical and radiographical evaluation of the use of Herbert screws versus conventional miniplates for fixation of mandibular anterior fractures (A Randomized Controlled Clinical Trial)

Document Type : Original Article

Authors

1 Lecturer of Oral and Maxillofacial surgery, Faculty of Dentistry, Alexandria University

2 Associate Professor of Oral and Maxillofacial surgery, Faculty of Dentistry, Alexandria University

Abstract

Objective: There are different treatment modalities for fixation of anterior mandibular fractures. Including bone plates, lag and Herbert screws.
This study aimed to compare between using Herbert screw versus two conventional miniplates for anterior mandibular fractures fixation concerning timing of surgery, mouth opening, bite force recovery and bone density along the fracture line.
Materials and methods: A randomized controlled clinical trial was carried included twenty patients divided into two equal groups, 10 patients each. The study group received two Herbert screws for fixation of the anterior mandibular fracture, the control group received two conventional miniplates. Clinically operation timing, maximum mouth opening and bite force recovery were assessed. The bone density along the fracture line among both groups was recorded.
Results: The time taken using either techniques was statistically insignificant (P= 0.156). A non-significant difference was found concerning the maximum mouth opening at one week (p= 0.505). In following intervals, a significant difference was detected (p <0.001). An increase in bite force recovery in both groups along all the follow up intervals was noticed; comparing all data between both groups, there was a statistically significant difference towards the study group ( p <0.001). Finally, a statistically significant difference was notable between both groups along the whole follow up period regarding the bone density (p < 0.001).
Conclusion: Herbert screws are found to be highly technique-dependent, requiring advanced surgical skills. Nonetheless, in terms of compression fixation, low cost, fewer devices and hardware required, and improved wound healing outcomes, they surpassed the other treatment modality.

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Egyptian Dental Journal
Volume 68, Issue 3 - Serial Number 2
Issue 3 - ِJuly (Oral Surgery)
July 2022
Pages 2123-2133

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