Osseous integrated screws are currently viewed as an attractive alternative to traditional arch bars for the application of maxillomandibular fixation in mandibular fractures. Publications in the literature address the superiority of this system regarding exposure to blood borne pathogens (i.e.- hepatitis, HIV); however, there have been no studies to date demonstrating its ability to establish and maintain proper occlusion. The current study reviews 102 consecutive mandible fractures, comparing the osseous integrated screws versus arch bars with various fracture patterns. Fifty-three fractures were treated with screw fixation, 35 with arch bars, and 14 with no maxillomandibular fixation. Of the 53 fractures that used screw fixation, 37 involved fractures within the dental arch (i.e.- symphaseal, parasymphaseal or body) while 32 of the 35 fractures utilizing arch bars involved the dental arch. There were no complications noted in the arch bar group, however 4 were seen in the screw fixation group. These included 1 malunion requiring corrective osteotomy, 1 nonunion and 2 infected fracture sites. Although the osseous integrated screw system has many allures regarding speed and safety, its ability to establish and maintain maxillomandibular fixation has not yet been adequately established and should warrant further inquiry.