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Intermaxillary Fixation and Rigid Fixation

Intermaxillary fixation and rigid fixation are two methods of fixation, a procedure for stabilizing broken bones and allowing them to grow together in the proper position.

Fixation is an important step in treating fractures. It is also a crucial part of orthognathic surgery, used to correct mandibular and maxillary deformities. Orthognathic surgery on the mandible and maxilla generally involves breaking the bones in a controlled way and then resetting them into correct positions. After the bone is set (a process called "reduction") a period of fixation ensures proper healing.

Oral and maxillofacial surgeons use two basic fixation techniques. One of these, intermaxillary fixation, involves binding the jaw shut with wires or elastic bands. The other, called rigid fixation, is a newer technique in which tiny screws or plates are attached directly onto the fractured sections of the jaw bone; it does not require physically binding the jaws shut.

Treatment

Depending on the type of fracture, intermaxillary fixation may be necessary for as short as two weeks, or as long as 6-8 weeks. In most cases, bars are placed on the upper and lower teeth, and wires between them secure the teeth together. In some cases, intermaxillary fixation can be accomplished in a much less restrictive manner with the use of elastic bands. Patients undergoing intermaxillary fixation have to stick to a liquid diet while their jaws are bound. In case of emergency, wire cutters should be kept at close reach to allow fast release from intermaxillary fixation.

Rigid fixation is becoming the preferred fixation technique when possible, because it is so much less disruptive to a patient's quality of life during recovery. However, applying the screws and plates directly onto the bone requires a much more invasive procedure. The metal plates used to attach bones together in rigid fixation are usually left in place permanently.

The oral and maxillofacial surgeon will determine the fixation technique most appropriate for each patient's individual case.

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