• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.3
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• pp.175-181
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• 2002

Intermaxillary fixation and occusal splint are routine procedure for maxillofacial fracture and orthognathic surgery. When these methods could obstruct oral airway the patients who kept intermaxillary fixation and occusal splint in their mouth, are very difficult to breath after surgery. Nasal bleeding and pharyngeal edema due to nasotracheal intubation, residual effect of muscle relaxants, and anesthetic agent could be contributing factor of airway obstruction. In this study, pulmonary function test was evaluated before and after intermaxillary fixation, and intermaxillary fixation with occusal splint in 22 volunteers. The results were as follows 1. FVC, %FVC, $FEV_1$, $FEV_1%$, PEF, $PEF_{50}$, MVV without intermaxillary fixtion were 4.45L, 88%, 4.03L, 90.9%, 10.26L/s, 5.53L/s, and 136.14L/min, and with intermaxillary fixation were 3.51L, 68.67%, 3.06L, 69.39L, 6.52L/s, 3.94L/s, and 69.39L/min. The results with intermaxillary fixation and occusal splint were 2.15L, 42.41%, 1.71L, 38.81%, 2.83L/s, 1.74L/s, and 37.14L/min. 2. Compared with before and after intermaxillary fixation, all values of pulmonary function test were decreased and after intermaxillary fixation and intermaixillary fixation with occulasal splint, the results were decreased. 3. MVV and PEF were decreased significantly with interaxillary fixtion and occusal splint, and FVC was less decreased. It meant that intermaxillary fixation and occluasal splint induced reduction of respiratory flow significantly, but less reduction of respiratory volume. 4. Intermaxillary fixation and occulsal splint induced increase of airway resistance, decrease of expiratory volume and air flow. So severe respiratory difficulty could be seen to all volunteers who kept intermaxillary fixtion and occusal splint. 5. In classification of respiratory difficulty, intermaxillary fixation with occulsal splint induced complex respiratory difficulty more than intermaxillary fixation only did. From the above results, doctors who care patients kept intermaxillary fixation and occusal splint should be aware of respiratory depression caused by these treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.361-366
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• 1999

Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.265-271
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• 2003

Skeletal relapse is known as a complication following orthognathic surgery of mandibular prognathism and occurring during intermaxillary fixation period. Therefore relapse of teeth and skeleton during intermaxillary fixation period is considered as a important problem of orthognathic surgery. In this study, cephalolateral radiographs taken at pre-operation, immediate post-operation and after release of intermaxillary fixation were measured for evaluation of dental and skeletal relapse in 30 cases. The cases were classified as screw fixation group and plate fixation group, then we compared magnitude of dental and skeletal changes of each group. The results were as follows 1. The $\underline{1}$ SN angle increased at immediate post-operation with a mean value of $0.12^{\circ}$ and at intermaxillary fixation period with a mean value of $0.43^{\circ}$ (p>0.05). 2. The $\overline{1}$ MP angle decreased with a mean value of $0.14^{\circ} at immediate post-operation and with a mean value of $1.28^{\circ} during intermaxillary fixation period but there were not significant difference(p>0.05). 3. There were not significant difference in magnitude of dental position changes between screw fixation group and plate fixation group(p>0.05). 4. Gonial angle increased with a mean value of $0.62^{\circ} during intermaxillary fixation period. Each group showed changes of gonial angle during intermaxillary fixation period but there were not significant difference(p>0.05).

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.96-98
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• 2015

Maxillomandibular fractures usually require intermaxillary fixation as a means to immobilize and stabilize the fracture and to re-establish proper occlusion. Arch bars or intermaxillary fixation screws cannot be used for edentulous patients or for patients who have poor dental health. Here, we present a case of repeated intermaxillary fixation failure in a patient weak alveolar rigidity secondary to multiple dental implants. Because single-point fixation screws were not strong enough to maintain proper occlusion, we have used Y-shaped plates to provide more rigid anchoring points for the intermaxillary wires. We suggest that this method should be considered for patients in whom conventional fixation methods are inappropriate or have failed.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.260-264
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• 2010

Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.477-482
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• 2006

The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.4
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• pp.233-236
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• 2014

In order to reduce jaw fracture accompanied by basal skull or nasal fracture, submental intubation could be generally performed. Albeit submental intubation has been widely accepted, it could develop complications such as nerve injury, glandular duct injury, and orocutaneous fistula. Here, we suggest oral intubation for overcoming complications and providing more stable surgical environment in emergency case. Under oral intubation maintaining in retromolar triangle and buccal corridor space, intermaxillary fixation was successfully underwent in 38-years-old female patient with Le Fort I fracture accompanied by pneumocephalus.

• Journal of Oral Medicine and Pain
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• v.39 no.4
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• pp.156-162
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• 2014

Dislocation of temporomandibular joint (TMJ) is troublesome condition which was most commonly shown far anteriorly displaced mandibular condyle to the articular eminence, thereby make it impossible to close one's mouth. It is often referred to as 'open lock' in clinically. Although anatomical modification of the articular eminence through eminectomy has been considered most satisfactory and efffective treatment for managing the recurrent dislocation, it seldom performs clinically due to its invasiveness and patient's reluctance. We thought a shortterm intermaxillary fixation could be of benefit to the patient suffering from recurrent dislocation. A 21-year-old male patient with recurrent TMJ dislocation which had developed after excessive mouth opening, was successfully treated with intermaxillay fixation using microimplant for 2 months. It is more conservative and less complicated method than eminectomy in treating recurrent TMJ dislocation. Transient intermaxillary fixation using microimplant and elastics could be one of treatment options for recurrent TMJ dislocation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.372-380
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• 2005

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.