Arch Bars -- How long to place?

[southomfs]

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Residents,

Curious to know how long it takes you to put on a pair of arch bars for the average patient -- don't include time to put little people on for MMF. Assume 1st molar to 1st molar.

Anyone know of any papers that look at speed of arch bar placement?

You can post here or pm me. Any help appreciated.

Thanks,
south

 

[OMSKooK]

In general, in my limited experience:

30-60 minutes if working alone
<30 if working as a team with another

There are many variables though:
1 - sedation vs local
2 - compliant patient vs thrasher
3 - stable occlusion available
4 - operator experience with wire and not fatiguing to breaking point

I am sure others can place a lot faster or slower, but that is my estimate. With greater speed comes greater chance of operator injury. There was a recent article by Herford (I think?) that evaulated archbars vs no archbars for for adequate reduction of fractures and there was a discussion on speed and danger of exposure to surgeon etc. I don't remember which journal exactly, probably JOMS.

 

[ArmyJawBreaker]

I would say 30-60 minutes for upper and lower arch bars. You must remember that some surgeons do not place wires around each tooth and I knew some ENT surgeons who would place only 4 wires on each arch bar. As you can see that would only take a couple of minutes, but it stability would definitely be compromised.

Easier to do arch bars under GETA, IV sedation arch bars are easier to place than on a local anesthesia patients.

Many variables are involved, all the way down to the anterior crowding of teeth.

Hope this helps.

 

[ObviousGuy]

I externed at a place a while ago where they timed themselves. Two residents, pt intubated in OR, 19 minutes from 1st M to 1st M U/L including wiring shut. Pretty impressive, heavy trauma program.

 

[flat4]

We did a set today in 26 minutes, my chief and myself, molar to molar in the OR. At the start of the case, our attending, a Parkland guy, was timing us and told us they had to be on in 15 minutes and was hazing us the whole time Broke two interdental wires in the process (I know we suck) and had a few calculus cock blocks. I think we can do 20 minutes but that's if everything goes perfect. Going at our own pace, takes us 30-40 minutes. Much safer this way in my opinion.

 

[mzalendo]

while impressive safety should always be your highest priority..... getting stuck or worse yet sticking your chief in order to cut down 5-10 minutes off OR time makes little sense

 

[aphistis]

while impressive safety should always be your highest priority..... getting stuck or worse yet sticking your chief in order to cut down 5-10 minutes off OR time makes little sense

Agreed. Having to wait on the results of a rapid HIV test will really kill your time.

 

[txdent2be2007]

Last month treated a GSW to mandible with MMF. 1st molar to 1st molar -- 18 minutes -- from first wire passed to MMF fish. We had anesthesia document it in their times for proof!