Abstract
Intermaxillary fixation is commonly employed in maxillofacial trauma to utilise functional occlusion as a tool to perform open reduction and internal fixation of maxillary and mandibular fractures. This new technique seems to be a simple, efficient and rapid modality to achieve intermaxillary fixation.
Intermaxillary fixation (IMF) or maxillomandibular fixation is commonly used in oral and maxillofacial surgery, most commonly in maxillofacial trauma before fixation of the fractures, to achieve a stable occlusion for ease of function.
Various wiring techniques are routinely used to achieve IMF, such as direct interdental wiring , interdental eyelet wiring , continuous or multiple loop wiring , and prefabricated arch bars . Newer techniques, such as IMF screws, have made IMF quicker and more efficient but there are associated complications. A rthur & B erardo were one of the first proponents of IMF screws, which have undergone several modifications, the most recent being a customised screw with washer .
The authors’ innovation is a quick, safe and efficient technique for achieving buccolingual IMF.
Technique
Four 7.5 in. (approximately19 cm) prestretched soft stainless steel wires, 26 gauge in diameter are used for this technique. They are passed through the right and left maxillary and mandibular canines and first molars. A wire is passed through the buccal side from the mesial and distal interdental area of the first maxillary molar tooth ( Fig. 1 A) . The wires are tightened palatally by twisting them together, forming a 1 cm tail in the molar region ( Fig. 1 B). In the canine region the tail needs to be about 1.5 cm. The ends of the wire are passed through the lingual side from the mesial and distal interdental area of the first mandibular molar tooth ( Fig. 1 C and D). The same is done with the other three wires around the canine teeth and the opposite first molar tooth ( Fig. 2 A) . The final twisting of all the four wires on the buccal aspect is done simultaneously to achieve buccolingual intermaxillary fixation ( Fig. 2 B).
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