Maxillomandibular fixation

Maxillomandibular Fixation (MMF) is a surgical procedure used in the field of Oral and Maxillofacial Surgery to treat a variety of conditions affecting the maxilla (upper jaw) and mandible (lower jaw). This procedure is commonly employed to stabilize the jaws following trauma, to correct dental malocclusions, or as part of the treatment for certain types of jaw tumors or pathologies. MMF involves the temporary immobilization of the jaws by fixing them together, ensuring proper alignment for healing.

Indications

Maxillomandibular fixation is indicated in several scenarios, including:

• Facial trauma involving fractures of the maxilla or mandible
• Orthognathic surgery to correct jaw misalignments or deformities
• Pre- and post-operative management of jaw tumors
• Stabilization of the jaw in cases of severe dental infections or periodontal disease
• Correction of severe dental malocclusions not amenable to conventional orthodontics

Procedure

The MMF procedure involves aligning the maxilla and mandible in the correct anatomical position and then fixing them together using various materials and techniques. These can include:

• Wiring of the teeth
• Application of arch bars
• Use of bone plates and screws
• Elastics or other forms of intermaxillary fixation devices

The choice of technique depends on the specific indications, the patient's dental anatomy, and the surgeon's preference. The goal is to immobilize the jaws to allow for proper healing of the bones and soft tissues.

Risks and Complications

As with any surgical procedure, MMF carries potential risks and complications, such as:

• Infection
• Damage to the teeth or periodontium
• Nerve injury, leading to numbness or altered sensation
• Difficulty in breathing, speaking, or swallowing
• Malnutrition due to restricted diet

Postoperative Care

Following MMF, patients are typically placed on a liquid or soft diet to prevent strain on the fixation. Oral hygiene is crucial, and patients are advised on how to maintain cleanliness around the wires or fixation devices. Regular follow-up appointments are necessary to monitor healing and to adjust or remove the fixation devices at the appropriate time.

Recovery

The duration of maxillomandibular fixation can vary from a few weeks to several months, depending on the reason for the MMF and the complexity of the case. After removal of the fixation devices, rehabilitation may include physical therapy for the jaws, orthodontics, or additional surgeries to achieve optimal function and aesthetics.