Clinical trial NCT03075865: A Cohort Study for Clinical Evaluation of OmniMax MMF System
Official title: The OmniMax MMF System: A Cohort Study for Clinical Evaluation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Mandibular Fractures
Keywords: intermaxillary fixation
maxillo-mandibular fixation
Lead sponsor: Zimmer Biomet
Sponsor class: INDUSTRY
Collaborators: name: University of Iowa
name: Medical University of South Carolina
name: University of California, Davis
First posted: 2017-03-09
Enrollment: 39
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adults involved in trauma events resulting in uncomplicated mandibular fractures and needing intermaxillary fixation for fracture repair and fracture healing.

Brief summary: OmniMax MMF system was designed as a device with faster application/removal time, less mucosal tissue overgrowth over the plates and screws, better tolerance for placement over prolong periods of time, better patient hygiene and a lower risk for further treatments secondary to root damage from the insertion of the screws, compared to the standard of care for maxillo-mandibular fixation and other hybrid systems. This clinical trial intends to highlight the clinical benefits of the OmniMax MMF system applied to patients undergoing repair of uncomplicated mandibular fracture(s) for whom OmniMax MMF system is used as a single mean for maxillo-mandibular fixation.

Detailed description: The objective of this study is to highlight and evaluate the clinical benefits of OmniMax MMF system applied to patients undergoing repair of uncomplicated mandibular fracture(s). A total of 50 subjects involved in trauma events resulting in uncomplicated mandibular fracture(s) will be enrolled at up to 5 sites from 3 surgical subspecialties: maxillofacial surgery, ENT, and plastic surgery. Subjects considered for participation will receive OmniMax MMF system for maxillo-mandibular fixation for a period of 4 to 8 weeks. Incidence of root damage associated with screw insertion, time for implantation and removal of the device, oral hygiene during the maxillomandibular fixation period, mucosal overgrowth, gingival necrosis, post-operative pain, stability of the occlusion, fracture healing, patient overall satisfaction/compliance with length of treatment, incidence of glove perforation and accidental puncture, will be evaluated in all participants who remain in IMF post-operatively. Adverse Events associated with the use of OmniMax MMF system will also be collected.

Eligibility criteria: Inclusion Criteria:

* Males or females
* 18 years of age or older
* Able and willing to sign ICF and medical photography consent
* Undergoing a surgical procedure to repair uncomplicated mandibular fracture(s) requiring open reduction internal fixation (ORIF) or closed maxillo-mandibular fixation (MMF)
* Fracture repair done within 10 days after facial trauma
* Use of OmniMax MMF system as a single mean for IMF (maxillary plate and mandibular plates together with no other device combined, such as Erich bars or IMF screws).

Exclusion Criteria:

* General contraindications unfavorable for the use of MMF (psychological disorders, seizures disorders, airway compromise, immune-compromised patients, etc).
* History of radiation therapy to the head or neck region.
* Limited blood supply to the area of device application.
* Insufficient quantity or quality of bone.
* History of foreign body sensitivity.
* History of previous use of bisphosphonates (i.e. alendronate, pamidronate, neridronate, olpadronate, ibandronate, risendronate, zolendronate).
* Clinically active or latent infection.
* Patients with less than 20 teeth.
* Deciduous dentition.
* Patients for whom the use of OmniMax MMF system would not be appropriate in judgment of the surgeon (i.e., excessive overjet or deep overbite).
* Mandibular fracture pattern that could prevent the use of OmniMax MMF system for adequate reduction and stabilization (i.e., comminuted fractures, dental alveolar fractures).

Primary outcomes:
measure: Root Damage
timeFrame: 6 weeks
Secondary outcomes:
measure: Time for Implantation of OmniMax MMF
timeFrame: Operative
measure: Tissue necrosis and mucosal overgrowth
timeFrame: 6 weeks
Other outcomes:
measure: Patient Satisfaction
timeFrame: 6 weeks
measure: Gloves Perforation and Accidental Puncture
timeFrame: Operative
Locations:
city: Sacramento
country: United States
facility: University of California Davis Medical Center
state: California
city: Iowa City
country: United States
facility: University of Iowa
state: Iowa
city: Charleston
country: United States
facility: College of Dental Medicine
state: South Carolina
Study officials:
affiliation: Zimmer Biomet CMF & Thoracic
name: Brian M Hatcher, PhD
role: STUDY_DIRECTOR
References:
citation: Engelstad ME, Kelly P. Embrasure wires for intraoperative maxillomandibular fixation are rapid and effective. J Oral Maxillofac Surg. 2011 Jan;69(1):120-4. doi: 10.1016/j.joms.2010.06.209. Epub 2010 Oct 29.
citation: Ansari K, Hamlar D, Ho V, Hilger P, Cote D, Aziz T. A comparison of anterior vs posterior isolated mandible fractures treated with intermaxillary fixation screws. Arch Facial Plast Surg. 2011 Jul-Aug;13(4):266-70. doi: 10.1001/archfacial.2011.46.
citation: Sahoo NK, Mohan R. IMF Screw: An Ideal Intermaxillary Fixation Device During Open Reduction of Mandibular Fracture. J Maxillofac Oral Surg. 2010 Jun;9(2):170-2. doi: 10.1007/s12663-010-0049-0. Epub 2010 Sep 22.
citation: Cornelius CP, Ehrenfeld M. The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature. Craniomaxillofac Trauma Reconstr. 2010 Jun;3(2):55-80. doi: 10.1055/s-0030-1254376.
citation: Roccia F, Rossi P, Gallesio C, Boffano P. Self-tapping and self-drilling screws for intermaxillary fixation in management of mandibular fractures. J Craniofac Surg. 2009 Jan;20(1):68-70. doi: 10.1097/SCS.0b013e318190df2f.
citation: Bagheri SC, Dimassi M, Shahriari A, Khan HA, Jo C, Steed MB. Facial trauma coverage among level-1 trauma centers of the United States. J Oral Maxillofac Surg. 2008 May;66(5):963-7. doi: 10.1016/j.joms.2008.01.020.
citation: Gaujac C, Ceccheti MM, Yonezaki F, Garcia IR Jr, Peres MP. Comparative analysis of 2 techniques of double-gloving protection during arch bar placement for intermaxillary fixation. J Oral Maxillofac Surg. 2007 Oct;65(10):1922-5. doi: 10.1016/j.joms.2006.06.311.
citation: Coletti DP, Salama A, Caccamese JF Jr. Application of intermaxillary fixation screws in maxillofacial trauma. J Oral Maxillofac Surg. 2007 Sep;65(9):1746-50. doi: 10.1016/j.joms.2007.04.022.
citation: Fabbroni G, Aabed S, Mizen K, Starr DG. Transalveolar screws and the incidence of dental damage: a prospective study. Int J Oral Maxillofac Surg. 2004 Jul;33(5):442-6. doi: 10.1016/j.ijom.2003.10.014.
citation: Ayoub AF, Rowson J. Comparative assessment of two methods used for interdental immobilization. J Craniomaxillofac Surg. 2003 Jun;31(3):159-61. doi: 10.1016/s1010-5182(03)00022-2.
citation: Vartanian AJ, Alvi A. Bone-screw mandible fixation: an intraoperative alternative to arch bars. Otolaryngol Head Neck Surg. 2000 Dec;123(6):718-21. doi: 10.1067/mhn.2000.111286.
citation: Valentino J, Marentette LJ. Supplemental maxillomandibular fixation with miniplate osteosynthesis. Otolaryngol Head Neck Surg. 1995 Feb;112(2):215-20. doi: 10.1016/S0194-59989570239-3.
citation: Hashemi HM, Parhiz A. Complications using intermaxillary fixation screws. J Oral Maxillofac Surg. 2011 May;69(5):1411-4. doi: 10.1016/j.joms.2010.05.070. Epub 2011 Jan 8.
citation: Nandini GD, Balakrishna R, Rao J. Self Tapping Screws v/s Erich Arch Bar for Inter Maxillary Fixation: A Comparative Clinical Study in the Treatment of Mandibular Fractures. J Maxillofac Oral Surg. 2011 Jun;10(2):127-31. doi: 10.1007/s12663-011-0191-3. Epub 2011 Apr 20.
citation: Rai A, Datarkar A, Borle RM. Are maxillomandibular fixation screws a better option than Erich arch bars in achieving maxillomandibular fixation? A randomized clinical study. J Oral Maxillofac Surg. 2011 Dec;69(12):3015-8. doi: 10.1016/j.joms.2010.12.015. Epub 2011 Apr 5.
citation: Schulte-Geers M, Kater W, Seeberger R. Root trauma and tooth loss through the application of pre-drilled transgingival fixation screws. J Craniomaxillofac Surg. 2012 Oct;40(7):e214-7. doi: 10.1016/j.jcms.2011.10.022. Epub 2011 Nov 17.
citation: Park KN, Oh SM, Lee CY, Kim JY, Yang BE. Design and application of hybrid maxillomandibular fixation for facial bone fractures. J Craniofac Surg. 2013;24(5):1801-5. doi: 10.1097/SCS.0b013e3182a21163.
citation: Chao AH, Hulsen J. Bone-supported arch bars are associated with comparable outcomes to Erich arch bars in the treatment of mandibular fractures with intermaxillary fixation. J Oral Maxillofac Surg. 2015 Feb;73(2):306-13. doi: 10.1016/j.joms.2014.08.025. Epub 2014 Aug 27.
citation: Ingole PD, Garg A, Shenoi SR, Badjate SJ, Budhraja N. Comparison of intermaxillary fixation screw versus eyelet interdental wiring for intermaxillary fixation in minimally displaced mandibular fracture: a randomized clinical study. J Oral Maxillofac Surg. 2014 May;72(5):958.e1-7. doi: 10.1016/j.joms.2014.01.005. Epub 2014 Jan 18.
citation: West GH, Griggs JA, Chandran R, Precheur HV, Buchanan W, Caloss R. Treatment outcomes with the use of maxillomandibular fixation screws in the management of mandible fractures. J Oral Maxillofac Surg. 2014 Jan;72(1):112-20. doi: 10.1016/j.joms.2013.08.001. Epub 2013 Sep 25.
citation: Meursinge Reynders R, Ladu L, Ronchi L, Di Girolamo N, de Lange J, Roberts N, Pluddemann A. Insertion torque recordings for the diagnosis of contact between orthodontic mini-implants and dental roots: protocol for a systematic review. Syst Rev. 2015 Apr 2;4:39. doi: 10.1186/s13643-015-0014-6.
citation: Laurentjoye M, Majoufre-Lefebvre C, Siberchicot F, Ricard AS. Result of maxillomandibular fixation using intraoral cortical bone screws for condylar fractures of the mandible. J Oral Maxillofac Surg. 2009 Apr;67(4):767-70. doi: 10.1016/j.joms.2008.06.055.