A study on fixation of mandibular fracture without intermaxillary fixation

An intermaxillary fixation conventionally used in reconstruction of the fractured mandible imposes an enormous amount of inconvenience lasting for 6-7 weeks on patients.Reconstruction of mandibular fracture without the use of an intermaxillary fixation has been developed. Of various methods so far developed, a method proposed by Champy has gained most widespread applications.In practical application, however, the Champy's method, which is regarded at present as most advantageous, must be performed within 6 hours after fracture and is thus restricted by time.In Japan, patients with mandibular fracture are rarely referred to oral surgeons within 6 hours after injury but almost always a day or two later at the earliest.This paper presents a new method developed for reconstruction of the fractured mandible without recourse to an intermaxillary fixation. The method can be applied to patients within 2 weeks after injury. A reconstructed mandibular model by simulation surgery is prepared and a metal cast arch bar is prefabricated using the above model. This arch bar is first fitted to the non-dislocated side of the dental arch. The dislocated side of the dental arch is then inserted into the arch bar. Finally Champy's miniplates are screwed to the lower margin of the mandibular body.Photoelastic stress analysis after fixation by this method disclosed normal distribution of stress such as seen in unfractured mandible.