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In the name of Allah, The MostIn the name of Allah, The Most CompassionateCompassionate,,
The Most MercifulThe Most Merciful
Reduction techniques for
mandibular fractures: Current
means of obtaining occlusion:
IMF vs. hand-holding
Muhammad Azhar Sheikh
MSc. (Lond), FDSRCS (Eng), FFDRCS (Ire)
FDS Oral Surg (UK)
Prof: Oral and Maxillofacial Surgeon
Islamic International Dental College, Isb
Trauma is the major cause of death
in children and young adults
Anatomic distribution
Desired Outcome
• Function
= Occlusion
• Aesthetics
Clinical Examination
Investigations
IMF techniques
Leonard buttons
Intra Oral Cortical Bone screws
Intra oral cortical bone
screws
Rapid IMPF (Anchorage ties
and Power Chain)
Rapid IMF
Rapid IMF (Anchorage Ties)
• Rapid – save about 40% time
compare to eyelet IMF
• More tooth related complications
like crown dislodgement
Lag Screw – IMF?
Hand held technique
• Quick - half time compare to IMF
• No gadgetry of IMF
• No risk of wire injury
• Cheap
• Short anaesthesia & stay
• Less complications (Systemic & Local)
• Similar outcome of occlusion
Hand held technique
• Operator sensitive
• Experience & Skill required
• Competent assistant
• Relatively early Fracture
Summery – ORIF mandible
• Most cases can be done with
hand held technique with its
advantages
• IMF while plating is necessary
in complicated cases
• No compromise on occlusion
07 mandible, means of imf, imp vs hand holding

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