![]() ![]() In dentate patients, tooth-borne devices such as chain-linked interdental wires, wired arch bars, or cast metal cap splints were used for many decades. In essence, a more or less complex, mostly metallic framework was attached to the teeth to provide support and anchor points for fixation of the jaws with interconnecting elastics or wires between the dental arches. 1, 2, 3 Historically, a plethora of techniques has been offered to join the mandible with the maxilla. MMF is employed in orthognathic surgery, and occasionally to induce weight loss in morbid obesity. Temporary intraoperative MMF is distinguished from prolonged MMF maintained for varying time periods postoperatively as a conservative modality for fracture treatment. Intermaxillary (mandibulo-maxillary fixation, MMF) is regarded as the crucial step in the management of maxillofacial trauma since it secures the interrelationship of the occlusal surfaces, which is the absolute essential step in reduction of fragments in both jaws. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. ![]() On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. ![]() In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. ![]() The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. ![]()
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