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VOLUME 25 , ISSUE 3 ( March, 2024 ) > List of Articles


Simple Method for Re-tightening IMF Wires without Breakage

Sandeep K Madhu, Shiney Dominic, Joanna Baptist, Premalatha Shetty

Keywords : Intermaxillary fixation, Loop, Maxillofacial trauma, Occlusion

Citation Information : Madhu SK, Dominic S, Baptist J, Shetty P. Simple Method for Re-tightening IMF Wires without Breakage. J Contemp Dent Pract 2024; 25 (3):289-291.

DOI: 10.5005/jp-journals-10024-3650

License: CC BY-NC 4.0

Published Online: 19-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Aim: This clinical technique aims to retighten intermaxillary fixation (IMF) wires when loosened intra/postoperatively. Background: Intermaxillary fixation is one of the most important steps to obtain stable and functional occlusion in maxillofacial trauma. However, IMF wires tend to loosen over time. This loosened wire is generally removed and a new wire is used for IMF. Removal and refixation is time-consuming for surgeon and unconformable for the patient. Technique: We recommend a simple technique for re-tightening IMF wires without breakage, with the use of shepherd's crook explorer by making a small circular loop. Conclusion: This technique of re-tightening by looping further stretches and tightens the wire to regain stabilized occlusion with maximal intercuspation. Clinical significance: This technique eliminates the need for removal and refixation of IMF wires, thereby improving patient comfort, yet obtaining stable occlusion over a long period of time.

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  1. Williams JL, Rowe NL. Rowe and Williams’ Maxillofacial injuries.2nd Ed. New York: Churchill Livingstone; 5 December 1994.
  2. Bhattacharjee A, Khatua A, Kumar V, et al. A new single wire technique for intermaxillary fixation–easy way out. Ann Int Med Dent Res 2017;4(1):12–13. DOI: 10.21276/aimdr.2018.4.1.DE3.
  3. Akadiri OA, Omitiola OG. Maxillo-mandibular fixation: Utility and current techniques in modern practice. Niger J Med 2012;21(2): 125–133. PMID: 23311177.
  4. Rai A, Jain A, Datarkar A, et al. Intermaxillary fixation with two loop wires: The Rai technique. Br J Oral Maxillofac Surg 2020;58(5):613–614. DOI: 10.1016/j.bjoms.2020.04.001.
  5. Coletti DP, Salama A, Caccamese JF Jr. Application of intermaxillary fixation screws in maxillofacial trauma. J Oral Maxillofac Surg 2007;65(9):1746–1750. DOI: 10.1016/j.joms.2007.04.022.
  6. Roccia F, Tavolaccini A, Dell'Acqua A, et al. An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screws. J Craniomaxillofac Surg 2005;33(4):251–254. DOI: 10.1016/j.jcms.2005.02.005.
  7. Falci SG, Douglas-de-Oliveira DW, Stella PE, et al. Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? A systematic review. Med Oral Patol Oral Cir Bucal 2015;20(4):e494–499. DOI: 10.4317/medoral.20448.
  8. Luhr HG. The significance of condylar position using rigid fixation in orthognathic surgery. Clin Plast Surg 1989;16(1):147–156. PMID: 2924488.
  9. King BJ, Christensen BJ. Hybrid arch bars reduce placement time and glove perforations compared with Erich arch bars during the application of intermaxillary fixation: A randomized controlled trial. J Oral Maxillofac Surg 2019;77(6):1228.e1–1228.e8. DOI: 10.1016/j.joms.2019.01.030.
  10. Kukreja P, Mangla M, Rajput L, et al. Effect of pre-stretching of surgical stainless steel wires on their ultimate load bearing strength—a prospective study. J Dent Spec 2016;4:36–38. DOI: 10.5958/2393-9834.2016.00007.3.
  11. Kapse S, Surana S, Shastri AK. Transpalatal wiring for the management of sagittal fracture of the maxilla/palate. Int J Oral Maxillofac Surg 2017;46(8):1059–1060. DOI: 10.1016/j.ijom.2017.02.1271.
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