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Simplifying intermaxillary fixation in orthognathic surgery using customized surgical archwire with clear aligners: a
Solène Chanteux1, Cyril Debortoli1, Frédérique Bally-Genet2
1Department of Oral and Maxillofacial Surgery, Head and Neck Institute, University Hospital of Nice, Nice France.
Journal of Stomatology, Oral and Maxillofacial Surgery
|November 20, 2025
Summary
A novel cobalt-chromium surgical archwire technique enhances clear aligner use in orthognathic surgery. This method provides stable fixation, expanding aligner applications to complex cases.
Area of Science:
- Orthodontics
- Oral and Maxillofacial Surgery
- Biomaterials
Background:
- Clear aligners are increasingly used in orthognathic surgery.
- Current limitations include insufficient intraoperative anchorage for stable intermaxillary fixation, restricting use to milder cases.
Purpose of the Study:
- To present a simplified, reproducible, and cost-effective technique for stable intermaxillary fixation in clear aligner-treated patients undergoing orthognathic surgery.
- To introduce a customized cobalt-chromium surgical archwire for enhanced intraoperative anchorage.
Main Methods:
- A 47-year-old female patient with skeletal Class III malocclusion underwent bimaxillary orthognathic surgery with clear aligner treatment.
- A CAD-designed cobalt-chromium archwire with interdental posts was bonded using a standard adhesive protocol.
- The procedure, including optional use of a positioning key for accuracy, took approximately 25 minutes.
Main Results:
- The technique provided rigid and evenly distributed anchorage without requiring removal of aligner attachments or addition of brackets/screws.
- Precise intraoperative traction was achieved without detachment or deformation of the archwire.
- The procedure demonstrated high accuracy and reproducibility.
Conclusions:
- This archwire technique offers stable intra- and postoperative fixation, overcoming a key limitation in aligner-based orthognathic surgery.
- It expands the applicability of clear aligners to complex cases, including segmental osteotomies and asymmetrical corrections.
- The method improves the integration of clear aligners into contemporary surgical workflows.
