Comparison Between Occlusal Versus Apical Bent Wires in Patients on Erich Arch Bar

Universiti Sains Malaysia24 enrolled

Overview

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)

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Maxillofacial Injuries

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18 years - 60 years old. * Full Glasgow coma scale. * Facial fractures requiring Erich arch bar for 4 weeks duration * No functional deficit that will prevent tooth brushing. Exclusion Criteria: * All pathologic fractures due to cysts, tumors, and cancers * Medical conditions that contraindicate the usage of arch bars (Epilepsy, Asthmatics)

Outcomes

Primary Outcomes

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'.

Time frame: 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'.

Time frame: Assessed on the fourth week

Secondary Outcomes

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.

Time frame: 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.