Mandibulomaxillary fixation with bone anchors and quick-release ligatures

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Trauma Surgery

Background:

• Mandibulomaxillary fixation (MMF) is crucial for treating maxillary and mandibular fractures.
• Traditional MMF techniques are problematic for patients with limited or no dentition, are time-consuming, and can be painful.
• Existing methods pose risks like glove punctures and patient discomfort during removal.

Purpose of the Study:

• To introduce and evaluate two novel, rapid techniques for establishing MMF.
• To assess the efficacy of these techniques across all age groups and dentition types.
• To compare the new methods with traditional MMF approaches regarding operative time, success rate, and patient satisfaction.

Main Methods:

• Developed two central skeletal MMF techniques using bone anchors (Microlugs or Mitek MiniGII).
• Anchors placed on the maxilla (pyriform rim) and mandible (symphysis).
• 112 patients (15 months-75 years) with facial fractures were treated using these techniques.

Main Results:

• Successful functional bone healing in 110 out of 112 patients.
• High success rates across primary, mixed, and secondary dentition, with or without splints/dentures.
• Significantly reduced operative times (7-20 minutes) and no glove punctures.
• Malocclusion occurred in only 1.8% of patients.
• Superior patient satisfaction due to less painful MMF removal.

Conclusions:

• The new bone anchor techniques provide a rapid, effective, and well-tolerated method for MMF.
• These techniques overcome limitations of traditional MMF, particularly in patients with challenging dentition.
• The methods result in excellent functional bone healing and high patient satisfaction.