Sample Solution

tudies by Choi et al. using silicon mandibular models have established the optimum position of the modified towel clamp–type reduction forceps relative to symphyseal and parasymphyseal fractures. Fractured models were reduced at three different horizontal levels: midway bisecting the mandible, 5 mm above midway, and 5 mm below midway. Besides, engagement holes were tested at distances of 10, 12, 14, and 16 mm from the fracture line. The models were subjected to heating up to 130°C for 100 minutes and then were cooled to room temperature. Stress patterns were then evaluated using a polariscope. Optimal stress patterns (defined as those distributed over the entire fracture site) were noted when the reduction forceps were placed at the midway or 5 mm below midway and at least 12 mm from the fracture line for symphyseal or parasymphyseal fractures and at least 16 mm for mandibular body fractures.
Shinohara et al. in 2006 used two modified reduction forceps for the symphyseal and parasymphyseal fractures. One was applied at the inferior border and another one in the subapical zone of the anterior mandible, to reduce lingual cortical bone sufficiently. In the other clinical studies, the reduction was achieved by using one clamp or forceps in the anterior and posterior region of the mandible.
One study describes that two monocortical holes were drilled, each 10 mm from the fracture line (Žerdoner and Žajdela, 1998). A second study describes monocortical holes at approximately 12 mm (Kluszynski et al., 2007) from the fracture line at midway down the vertical height of the mandible. The third study describes either monocortical or bicortical holes depending on difficulties. These difficulties are not described in detail. In this study, the distance of 5-8 mm from the fracture was chosen (Rogers and Sargent, 2000) at the inferior margin of the mandible.
Taglialatela Scafati et al., (2004) used elastic rubber bands stretched between screws placed across both sides of the fractured parts to reduce mandibular and orbit- maxillary fractures. Orthodontic rubber bands and two self-tapping monocortical titanium screws with 2 mm diameter and 9-13 mm length used. The heads of the screws protruded about 5 mm and the axis had to be perpendicular to the fracture line. It is similar in concept to other intraoperative methods of reduction used in orthopaedic o