Maxillo-mandibular fixation: utility and current techniques in modern practice.

ABSTRACT

BACKGROUND: There appears to be a gradual relegation of maxillo-mandibular fixation (MMF) from the frontline of oral and maxillofacial surgical techniques because of the evolution and increasing sophistication of rigid internal fixation techniques, efficiency. AIM: To highlight the residual relevance, utility, and current techniques of achieving MMF in modern practice. METHODS: A rigorous search of the maxillofacial literature was undertaken to identify recent articles that discuss the techniques, usefulness, limitations, merits, demerits and cost effectiveness of MMF. A narrative review of the selected literature was done to provide concise and current evidence on MMF in modern maxillofacial surgery. The cost effectiveness of MMF as a modality in the treatment of maxillofacial fractures is also compared with that of open reduction and internal fixation (ORIF). RESULTS: MMF is employed as temporary intraoperative adjunct to rigid fixation techniques or as a supplement for postoperative stabilization after semi-rigid fixation. It is a adequate and more cost effective method in some types of mandibular fractures. Other indications are patients' refusal of open surgery, refusal of hardware insertion and lack of medical fitness for extensive surgical operation. Many innovative techniques of achieving MMF are now available and are in this article, categorized into MMF with direct wiring techniques, MMF with inter-arch straight tie wires or elastics, and MMF with Special devices. CONCLUSION: In spite of the growing enthusiasm for ORIF, MMF remains a relevant technique in maxillofacial surgery and in some cases are more cost effective than rigid internal fixation.