Supplemental Internal Wire Suspension in Orthognathic Surgery Fixation

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Skeletal Trauma Management

Background:

• Historically, internal wire suspensions were employed for maxillary trauma and orthognathic procedures.
• Rigid internal fixation using bone plates and screws is the current standard of care.
• Patient factors like poor bone thickness can compromise the stability of rigid fixation.

Observation:

• A case involving bimaxillary osteotomy in a skeletal class III patient is presented.
• Instability of the maxilla was noted following standard rigid internal fixation.
• This instability was attributed to insufficient bone thickness for adequate screw purchase.

Findings:

• A supplemental circum-zygomatic-mandibular suspension technique was utilized to enhance maxillary stabilization.
• This adjunctive method provided the necessary stability where rigid fixation alone was insufficient.
• The case demonstrates a viable solution for complex orthognathic cases with compromised bone quality.

Implications:

• Circum-zygomatic-mandibular suspension can serve as a valuable adjunct in specific orthognathic surgery scenarios.
• This technique may improve outcomes for patients with poor bone stock, reducing the risk of fixation failure.
• Further research into the long-term efficacy and indications for supplemental suspension techniques is warranted.