الفهرس 
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Abstract
The present study was conducted to compare between Herbert screw fixation versus plates and screws fixation both clinically and radiographically, in treatment of anterior mandibular fractures.
The study involved eighteen adult patients suffering from fracture of anterior mandible selected from outpatient clinic and in patient department of the CranioMaxilloFacial Surgery Department, Nasser Institute Hospital for Research and Treatment & from the outpatient clinic, Oral and Maxillofacial Surgery Department at Ain Shams University.
A prospective comparative study was carried out in those patients with the following inclusion and exclusion criteria:
Inclusion criteria:
• Fit and well patients whom have no medical compromising conditions that affect bone or soft tissues healing.
• Only adult patients (over 18 to 50 years).
• Symphyseal or parasymphyseal fractures of the mandible.
• Dentate and partially dentate patients.
Exclusion criteria:
• Metabolic bone disease as osteoporosis.
• Comminuted anterior mandible.
• Associated pathological condition or pathological fractures.
• Infected fracture and osteomyelitis.
The patients were divided randomly into two groups equally according to the method of internal fixation as follows:
Study group: in this group 9 patients with anterior mandibular fractures was treated with ORIF using intraoral approach and insertion of intraosseous “Herbert screw” and bridal wire circumdental at the superior border.
Control group: in this group 9 patients with anterior mandibular fractures was treated with ORIF using intraoral approach and application of 2.3 plate at the inferior border and 2.0 plate at the superior border.
Clinical assessment was done for all patients according to the following schedule:
1) Immediate postoperative.
2) Two weeks postoperative.
3) Two months postoperative.
Radiographic assessment was done for all patients according to the following schedule:
1) Preoperative CT and OPG.
2) Immediate postoperative CT and OPG.
3) Two months postoperative OPG.
4) Six months postoperative CT.
The collected data were tabulated and statistically analyzed.
Conclusion
Concerning the main outcome of radiographic findings, the mean distance between two rami showed statistical significant change in the control group rather than the study group among a six-months period.
from the results of this research we concluded that Herbert screw fixation of mandibular symphysis and parasymphysis fractures offers adequate compression of fractured segments and have some advantages including low cost, require fewer instruments and less hardware compared to other forms of miniplate fixation. However, Herbert fixation is a technique sensitive and require skills for proper adjustment of angulation of the Herbert screw.
The Herbert screw can provide sufficient fixation and stability to allow bone healing and fast normal function of the jaw. In addition, the screw allows satisfactory compression to provide contact bone healing by primary intention without any gap between segments.
The armamentarium used for Herbert screw fixation was fewer than that used in plates and screws fixation, which was reflected on the operation