Cornelius Carl-Peter, Liokatis Paris Georgios, Doerr Timothy, Matic Damir, Fusetti Stefano, Rasse Michael, Gellrich Nils Claudius, Heiland Max, Schubert Warren, Buchbinder Daniel
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Ludwig-Maximilians University Munich, 80337 Munich, Germany;
Department of Otolaryngology, University of Rochester Medical Center, Rochester, NY 14642, USA;
Craniomaxillofac Trauma Reconstr. 2025 Jul 15;18(3):33. doi: 10.3390/cmtr18030033. eCollection 2025 Sep.
Trends in the utilization of Mandibulo-Maxillary Fixation (MMF) are shifting nowadays from tooth-borne devices over specialized screws to hybrid MMF devices. Hybrid MMF devices come in self-made Erich arch bar modifications and commercial hybrid MMF systems (CHMMFSs).
We survey the available technical/clinical data. Hypothetically, the risk of tooth root damage by transalveolar screws is diminished by a targeting function of the screw holes/slots.
We utilize a literature review and graphic displays to disclose parallels and dissimilarities in design and functionality with an in-depth look at the targeting properties.
Self-made hybrid arch bars have limitations to meet low-risk interradicular screw insertion sites. Technical/clinical information on CHMMFSs is unevenly distributed in favor of the SMARTLock System: positive outcome variables are increased speed of application/removal, the possibility to eliminate wiring and stick injuries and screw fixation with standoff of the embodiment along the attached gingiva. Inferred from the SMARTLock System, all four CHMMFs possess potential to effectively prevent tooth root injuries but are subject to their design features and targeting with the screw-receiving holes. The height profile and geometry shape of a CHMMFS may restrict three-dimensional spatial orientation and reach during placement. To bridge between interradicular spaces and tooth equators, where hooks or tie-up-cleats for intermaxillary cerclages should be ideally positioned under biomechanical aspects, can be problematic. The movability of their screw-receiving holes according to all six degrees of freedom differs.
CHMMFSs allow simple immobilization of facial fractures involving dental occlusion. The performance in avoiding tooth root damage is a matter of design subtleties.
如今,下颌-上颌固定(MMF)的应用趋势正从牙支持式装置转向专用螺钉,再转向混合式MMF装置。混合式MMF装置包括自制的埃里希牙弓夹板改良型和商用混合式MMF系统(CHMMFSs)。
我们调查现有的技术/临床数据。假设通过螺钉孔/槽的靶向功能可降低经牙槽螺钉损伤牙根的风险。
我们利用文献综述和图表展示来揭示设计和功能方面的异同,并深入研究靶向特性。
自制的混合牙弓夹板在满足低风险根间螺钉植入部位方面存在局限性。关于CHMMFSs的技术/临床信息分布不均,有利于SMARTLock系统:积极的结果变量包括应用/拆除速度加快、消除钢丝和刺伤的可能性以及在附着龈处具有支距的螺钉固定。从SMARTLock系统推断,所有四种CHMMFs都具有有效预防牙根损伤的潜力,但受其设计特点和螺钉接收孔靶向的影响。CHMMFS的高度轮廓和几何形状可能会限制放置过程中的三维空间定向和可达范围。在生物力学方面,为了在根间间隙和牙赤道之间架桥,理想情况下应在此处放置用于颌间结扎的钩子或系紧夹板,这可能会有问题。它们的螺钉接收孔在六个自由度上的可移动性各不相同。
CHMMFSs可简单固定涉及牙列咬合的面部骨折。避免牙根损伤的性能取决于设计细节。