Hybrid maxillomandibular fixation versus arch bars:a prospective clinical study of efficiency, safety, and patient outcomes

Abstract

Abstract
Background: Mandibular fractures are commonly managed using maxillomandibular fixation (MMF) to re-establish occlusion and facilitate bone healing. Conventional Erich arch bars (EAB) are widely used; however, they are associated with prolonged application time, increased intraoperative risks such as needle-stick injuries, and compromised patient comfort. Hybrid arch bar (HAB) systems have been introduced as an alternative, aiming to enhance efficiency and overall patient experience.

Objective: To compare the efficiency, safety, oral hygiene status, and patient comfort between hybrid arch bars and conventional Erich arch bars in the management of mandibular fractures.

Methods: This prospective clinical study was conducted at the Department of Oral and Maxillofacial Surgery in a private hospital in Karachi from January to July 2025. A total of 60 patients requiring temporary MMF were included and randomly allocated into two groups: HAB (n = 30) and EAB (n = 30). Baseline characteristics were comparable between groups. Outcome measures included application time, intraoperative complications, postoperative occlusal stability, oral hygiene status, and patient-reported comfort assessed using a Visual Analog Scale.

Results: The HAB group demonstrated a significantly shorter application time compared to the EAB group (18.4 ± 3.2 vs 32.7 ± 4.6 minutes; p < 0.001). Intraoperative complications were lower in the HAB group (10.0%) compared to EAB (23.3%; p = 0.04). Occlusal stability showed no significant difference between groups (p = 0.64). Oral hygiene was significantly better in the HAB group (p = 0.01), and patient comfort scores were higher (7.9 ± 1.1 vs 5.6 ± 1.4; p < 0.001).
Conclusion: Hybrid arch bars offer a faster, safer, and more comfortable alternative to conventional.