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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 1999 March;48(3):93-100
Maxillomandibular fixation by monocortical screws. Clinical indications and surgical techniques
Govoni F. A., Pistilli R., Piccolino P., Cassoni A., Matteini C.
Background. Intermaxillary fixation is one of the most reknown and widely used techniques in maxillofacial traumatology. It's carried out usually by means of direct criss-cross teeth wiring or through the wiring of a metallic arch-bar on the upper and lower jaws. These techniques are time-consuming operations, they can produce dental or periodontal damages, and are not well tolerated by the patient, even under local anesthesia. Recent experiences in oral implantology and in the use of miniscrews for rigid internal fixation suggest the experimentation of new, easy to use and better tolerated systems for bone-anchored intermaxillary fixation.
Methods. 1-0 stainless steel wires and titanium monocortical screws, 2 mm of diameter and 12 and 15 mm of lenght, have been used as alveolar-bone anchorages for the intermaxillary fixation of 10 mandibular fractures. The fixations have been performed either under general or local anesthesia, with 2, 4 or 6 points of alveolar bone anchorage, maintaining the fixation for 15 days in condylar fractures and for 40 days in all the other cases.
Results. A really good compliance of the patient towards all the procedures performed under local anesthesia, with a clear reduction of post-operative discomfort has been observed. Infection or rejection of the implanted screws did not occur as well as cases of alveolar or dento-parodontal damages.
Conclusions. This preliminary report on a new intermaxillary fixation technique didn't point out any significant complication of the procedure, showing at the same time that this technique can be easily performed under local anesthesia on out-patients with a better compliance, lower postoperative discomfort and good skeletal stability.