Comparison between different intermaxillary fixation systems in the surgical and orthopedic treatment of non-condylar mandibular fractures. Systematic review

The treatment of mandibular fractures can be orthopedic and/or surgical; in both modalities, intermaxillary fixation is a therapeutic tool that allows for the stabilization and reduction of fractures, guiding dental occlusion There are different methods of intermaxillary fixation, each with individual characteristics that provide therapeutic options for the practitioner. This study aims to perform a quantitative and qualitative comparison of different features of these intermaxillary fixation systems through a systematic review. A systematic review was performed, following the PRISMA guidelines. The Pubmed, SCOPUS, Web of Science and Cochrane databases were searched. Several variables were considered and are presented comprehensively in Tables and Figures. The initial literature search resulted in 51 articles, of which 9 met the inclusion criteria for the analysis. Of the 51 identified articles, 28 were analyzed, with 19 excluded after full-text evaluation. Ultimately, 9 studies with 3,221 patients were included, comparing Erich arch bars (EAB), hybrid arch bars (HAB), and intermaxillary fixation screws (IMFS). Discussion: The studies focused on simple fractures with sufficient teeth for orthopedic treatment, excluding isolated maxillary fractures. Results showed differences in installation time, occlusal stability, oral hygiene, and costs, with EAB being the most expensive. Patient quality of life and complications, such as screw loss and root perforations, were also evaluated. Most studies presented a low risk of bias. Screw-based methods like IMFS and HAB offer shorter installation times than EAB, reducing surgery duration, costs, and biosecurity risks. While EAB remains a valid option, screw methods provide advantages in time, hygiene control, and biosecurity, with the choice depending on patient needs and surgical experience.