Maxillomandibular Fixation



Maxillomandibular Fixation


Cherry L. Estilo

SaeHee Kim Yom

Joseph D. Randazzo





DEFINITION



  • Maxillomandibular fixation (MMF), also called intermaxillary fixation, involves fixation of fractures or residual components (following surgical resection) of the mandible or maxilla by applying elastic bands or stainless steel wire between the maxillary and mandibular arch bars.


  • Occlusion is the relationship between the maxillary and mandibular teeth as they contact one another. In this chapter, the term “occlusion” refers to the occlusion when the jaw is closed.


ANATOMY



  • MMF serves two purposes:



    • To stabilize and align the jaws into appropriate occlusal relationship to maintain preoperative occlusal status


    • To assist in maximizing the precision of the reconstruction


  • Presence of full or near-full complement of healthy dentition (especially, in the posterior region) is ideal for successful MMF.


PATIENT HISTORY AND PHYSICAL FINDING



  • A thorough oral and dental clinical examination is completed.


  • The periodontal status of the teeth and the condition of existing restorations or fixed prosthesis are evaluated to determine the ideal teeth for fixation.


  • The occlusal relationship and any mandibular deviation are noted.


IMAGING



  • Along with clinical examination (FIG 1A), a panoramic radiograph (and selected dental radiographs, if necessary) examination is completed to assess the overall health and stability of the patient’s dentition.


  • When indicated, selected dental (periapical or bite-wing) radiographs are obtained (FIG 1B).


SURGICAL MANAGEMENT



  • Equipment (FIG 2)


  • Erich arch bars


  • Stainless steel ligature wire (24 gauge)


  • Wire cutters


  • Needle holders


  • Band pusher


  • Elastics (red rubber whistle tip catheter size 14 French, cut in 3-mm thickness)






FIG 1 • A. Occlusion prior to mandibular resection. B. Periapical radiograph.






FIG 2 • Tools necessary for MMF.

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Dec 15, 2019 | Posted by in Reconstructive surgery | Comments Off on Maxillomandibular Fixation

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