Johnson Alan Wellington, Akkina Sarah Rathnam, Bevans Scott Eric
Hennepin Healthcare, Minneapolis, Minnesota, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Utah Health, Salt Lake City, Utah, USA.
Facial Plast Surg Aesthet Med. 2025 Jan-Feb;27(1):98-105. doi: 10.1089/fpsam.2024.0113. Epub 2024 Oct 28.
Numerous techniques achieve maxillomandibular fixation (MMF), each with benefits and risks. While using Erich arch bars to achieve MMF has remained the gold standard through the last century, the technique has multiple limitations, which have spurred innovative approaches, such as intermaxillary fixation (IMF) screws, hybrid arch bars, embrasure wires, and dental occlusion ties. The surge in new MMF technologies over the past decade prompted this analysis to compare these techniques. A PubMed search was conducted to identify all current FDA-approved modern MMF technologies from 2005 through 2023, evaluating their advantages and limitations. Studies with controlled scientific comparisons of techniques were limited, precluding a systematic review. Analysis showed no definitive data exist to endorse one technique as a universal option. As multiple MMF options offer appropriate stability, a surgeon may choose an approach based upon numerous factors: comminution/instability; need for physiotherapy, including guiding elastics; safety; time of application/removal; and patient comfort. This article guides the selection between techniques based on these factors and presents a decision algorithm to assist surgeons in selecting the ideal MMF technique for each patient.
有多种技术可实现上颌下颌固定（MMF），每种技术都有其优缺点。在过去的一个世纪里，使用 Erich 牙弓夹板实现 MMF 一直是金标准，但该技术存在多种局限性，这促使了一些创新方法的出现，如颌间固定（IMF）螺钉、混合牙弓夹板、牙间隙钢丝和牙合扎带。过去十年中，新型 MMF 技术的涌现促使进行了此项分析，以比较这些技术。通过 PubMed 检索，确定了 2005 年至 2023 年期间所有当前 FDA 批准的现代 MMF 技术，并评估了它们的优缺点。关于技术的对照科学比较研究有限，无法进行系统综述。分析表明，没有确凿数据支持将一种技术作为通用选择。由于多种 MMF 选项都能提供适当的稳定性，外科医生可以根据多种因素选择一种方法：粉碎性骨折/不稳定性；是否需要物理治疗，包括使用引导弹力带；安全性；应用/移除时间；以及患者舒适度。本文基于这些因素指导技术选择，并提出一种决策算法，以协助外科医生为每位患者选择理想的 MMF 技术。
