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Maxillomandibular Fixation: Understanding the Risks and Benefits of Contemporary Techniques in Adults.

Facial plastic surgery & aesthetic medicine·2024
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Techniques for maxillomandibular fixation: old and new.

Sarah Rathnam Akkina1, Scott Eric Bevans2, Alan Wellington Johnson3

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Utah Health.

Current Opinion in Otolaryngology & Head and Neck Surgery
|April 1, 2025
PubMed
Summary

Maxillomandibular fixation (MMF) techniques vary in effectiveness and risks. Arch bars offer robust fixation for complex fractures, while newer methods like dental occlusion ties provide faster application and improved patient comfort.

Keywords:
facial fracturefacial traumaintermaxillary fixationmaxillomandibular fixation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomedical Engineering
  • Orthodontics

Background:

  • Maxillomandibular fixation (MMF) is a critical component in treating midface and lower jaw fractures.
  • Advancements in surgical techniques have led to a proliferation of MMF methods, each with distinct advantages and disadvantages.
  • Understanding the evidence supporting various MMF techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To review current trends in maxillomandibular fixation (MMF) techniques.
  • To evaluate the evidence supporting and opposing prevalent MMF methods.
  • To provide a comprehensive catalog of MMF approaches for surgical decision-making.

Main Methods:

  • Systematic review of recent literature on MMF techniques.
  • Analysis of comparative studies on different MMF methods.
  • Cataloging of MMF trends, including traditional and novel approaches.

Main Results:

  • Erich arch bars are robust for complex fractures but increase operative time and risk complications.
  • Screw-based techniques are faster but may not stabilize severe fractures and carry risks of tooth/nerve damage.
  • Embrasure wires and dental occlusion ties offer time savings and reduced complications but have limitations based on fracture severity and dentition.

Conclusions:

  • Each maxillomandibular fixation (MMF) technique presents unique benefits and drawbacks.
  • The choice of MMF method should be tailored to surgical objectives, fracture complexity, and patient-specific factors.
  • Considerations include fixation stability, occlusion maintenance, procedure time, safety, and patient comfort.