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When recovering from jaw surgery to correct your bite, or jaw surgery as a result of an accident, you may need to have your jaw elasticised, or wired together.
The purpose of having your jaws elasticised, or wired together can be likened to wearing a cast or sling when breaking a bone in your body. It creates stability, ensures the bone is kept in the correct position and promotes healing by limiting the movement and trauma of the mouth.
Examples Of Inter-Maxillary Fixation
There are three main methods that your teeth can be brought can be brought into surgical Inter-Maxillary Fixation or (IMF).
See below for some examples:
Click on the following links to understand the process and different techniques of inter-maxillary fixation...
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Clinical photo showing placement of Orthodontic Cleats with elastics.
These are used in conjunction with orthodontic treatment and are placed onto the patient's braces. |
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Clinical photo showing placement of Eric arch bars.
Eric arch bars are fastened around each of the patient's teeth and wired above the gum line. |
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Clinical photo showing Inter-Maxillary fixation (FAMEY) screws with elastics. These special screws are set in the jaw bone and then elastics are used to hold the jaw in place. |
Normally elastics are placed on these devices to bring your teeth together into IMF. Wiring is rarely used, but your specialist Oral & Maxillofacial surgeon will determine whether or not this is the best option for the treatment required.
If the appliances are irritating your gums you should use soft wax to cover over the sharp projection points. Ask the nurse for as much wax as you would like, as well as replacement elastics.
| With jaw distraction surgery, & after the distractors are removed, IMF elastics are used to close the bite, in a method termed "callus-manipulation" |
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1. These elastics are used as training elastics, & are not normally as tightly used as in other circumstances
2. Normally there is some "give" which may allow for restricted
3. Use elastics only as directed by the surgeon, & strictly for the period of time & strength recommended |
It is important to strictly follow the instructions given to you, and to comply with the wearing of your elastics/wires.
The IMF devices are important for you to gain a long term, functional and inter-digitating dentition/occlusion.
Elastic Inter-maxillary fixation
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1. At Ocean Surgical Pty Ltd Giant Panda Strength (4½ Ounce medium strength, 7.9mm) elastics
a. these can be obtained from your orthodontist or surgeon
2. These elastics should be replaced every two to four days
3. You should have been given a mirror and elastics-clips to assist you with placement of your elastics
4. The elastics should be placed as tightly as possible in the following patterns...
a. a box
b. up-and-down-repeat, or
c. triangle pattern
5. A minimum of four elastics each side of the midline should be placed (total 8 elastics)
6. If you feel nauseated, or claustrophobic, carry a pair of scissors to enable ease of rapid elastic cutting
7. The elastics are usually placed for 1-2 weeks full-time, after which a period of 1-2 weeks night time use follows
8.The first few replacement sessions are with the surgeon, but the aim is to teach you how to take off & replace your own elastics periodically, & in the comfort of your own home |
Wire Inter-maxillary fixation
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1. This is rarely used. It is used because the degree of injury or surgery requires it
2. When used, it is not designed for periodic changes, & is likely to be in place for at leat 3-4 weeks
3. You are provided with a wire cutter, & you should carry this at all times for cutting at times of nausea or distress
4. Sometimes the wire can be replaced with elastics for 1-2 weeks of night time use |
Diet
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1. It is important that you maintain a liquid diet, & that you do not attempt to chew until directed
a. With lighter elastics, small amoutnts of chewing can be allowed for, but only with permission of the surgeon
2. It is possible to mould a straw, or otherwise a sucking-device that can go behind the back of your teeth
3. It is important that you not have milk products, as the milk is difficult to clean or rinse away, & can lead to increased rated of oral wound infections
4. Clear broth, low residue soup, Ensure, Enlive, Vitamin B complex drinks, energy drinks, blended fruit etc can be used & can be sucked up a straw |
Medications
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1. It is possible to take tablets and capsules with your elastics in place... but it can take some patience and practice
2. Some medications come in liquid form and are easily taken. Your antibiotics can be prepared as a syrup , or can be broken up and put into jam or honey
3. Capsules and tablets can be gently pushed along the side of the mouth (between the cheeks and teeth), and pushed into the space behind the back molar tooth, and then swallowed with a glass of water
a. If at all possible, tablets and capsules should be taken whole and taken by this method |
Oral Hygiene
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1. It is very hard to clean your teeth without rinsing or heavy brushing, both of which are NEVER TO BE DONE
2. You should maintain use of chlorhexidine mouth soaks (peppermint tasting) to maintain wound cleanliness, & use of anaesthetic mouth salts as per your normal oral surgery instruction sheet
a. The chlorhexidine mouth soaks kill bacteria and prevent plaque build up. They will lead to unsightly brown discolouration in some places. This discolouration should be removed by your dentist after the bands are removed
3. The practice advises you to purchase an OxiJet (or similar) system to assist you with cleaning
a. The practice will instruct you on how to use the OxiJet system
b. The OxiJet system is designed to help you remove food debris
4. In rare cases, and only if directed by your surgeon, you may periodically remove and replace your bands to assist with tooth and mouth cleaning
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