Clinical Experiences of New Intermaxillary Fixation Method without Tooth Ligation

ABSTRACT

In the treatment of maxillofacial injuries, proper intermaxillary fixation is very important in improving bone union and restoration of normal occlusion. The traditional methods of intermaxillary fixation consist of interdental wiring and ligating of arch bars to the teeth of each jaw. These methods have their fixation point within the tooth, which may afflict the tooth itself. The tooth ligation method is also unsatisfactory for partially or totally edentulous patients, necessitating adjunctive circumferential wiring and acrylic splint to effect fixation. Furthermore, because of excessive manipulations (about 14-20 wire) during interdental wiring, it increases the possibility of associated gingival and mucosal injuries, and infections acquired during operation due to skin punctures. The authors have devised an improved method of placing miniscrews into the maxilla and mandibular alveolar bone and using these miniscrews for points of intermaxillary fixation. This procedure has been used in 17 patients with variable mandible fracture. In these cases we obtained better results than those with teeth ligating methods. The advantages of author's method include easy placement and removal with minimal wiring, decreased operation time, decreased patient discomfort, reduced risk of tooth, periodontal tissues, and oral mucosa injuries, and reduced risk of delivering blood transmitted diseases (AIDS, hepatitis) by skin puncture. As far as the stabilization and oral hygiene are concerned, fixation method was found to be superior to tooth ligation methods. Moreover, in patients with multiple dental injuries, author's intermaxillary fixation method proved to be simple and safe. With these advantages, new intermaxillary fixation method without tooth ligation is very useful for mandibular fractures and maxillofacial operations.