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SCREW PLACEMENT
Maxilla
 | Total of 3 or 4 screws |
| Ideal position is above the teeth roots, one in the
midline and one on either side of the midline, posterior to the canine
roots. |
| The drill guide retractor is placed on mucosa in the
desired location. Using a 1.5mm drill bit, the drill bit is advanced
through mucosa down to bone, the drilling procedure should continue to
a maximum depth of 15mm using saline irrigation.
n Without moving the drill guide retractor, the appropriate screw is
placed into the drill guide and advanced transmucosally down to bone.
The screw hole on the surface of the bone is located and the screw is
turned in a clockwise direction. |
| Once the screw is fully engaged into the screw hole,
the drill guide is pulled back to retract the lip and cheek. |
| The screw is advanced until the concave shoulder of
the screw head is 1mm from the mucosal surface. |
| The screw may be readjusted for proper alignment of
the wire holes contained within the screw head. |
| The procedure is repeated for the other maxillary MMF
screws.
***Nonrestorable teeth and edentulous areas should be considered
as ideal locations for MMF screw placement. |
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SCREW PLACEMENT
Mandible
| Total of 3 or 4 screws |
| Anterior mandible fractures |
| Expose the fracture first (identify anatomical
structures: roots of teeth and mental nerve). |
| Place screws a distance of 1cm from either side of
the fracture below the roots of the teeth |
| Screw holes are prepared bicortically with a 1.5mm
drill bit. |
| Place additional MMF screws opposite the maxillary
MMF screws as necessary. |
| Posterior mandible fractures |
| Screws are placed transmucosal, below the roots of
teeth and away from the mental nerve, opposite to the maxillary MMF
screws. |
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WIRE APPLICATION
| Utilize the assorted wire loop posts located on the
undersurface of the module cover, form a wire loop, which is similar
to the desired MMF screw configuration. |
| The wire loop is placed over the MMF screw head’s
concave beveled shoulder and the wire is twisted down to the opposite
interarch MMF screw. (This will prevent over tightening of the wire
and wire breakage). The MMF screws may also be advanced to further
tighten the wire. |
| Alternatively, a length of wire may be passed through
the wire holes or wire groove contained within the head of the MMF
screw and then tightened down onto the screw. |
| The number of wires placed and their configuration is
determined by the surgeon. |
INTRA-ARCH FRACTURE STABILIZATION IN
ANTERIOR MANDIBULAR FRACTURES
| After MMF is achieved and the fracture is reduced,
the MMF screws on either side of the fracture may be utilized to
further reduce and stabilize the fracture while the fixation device is
applied. |
| A length of wire may be passed through the screw
holes or groove contained within the head of the MMF screws, or
preferably, a wire is passed under the intermaxillary wire and
concaved beveled shoulder on the head of the MMF screw. |
| The wire is tightened. The MMF screws may be advanced
further to increase the tautness of the wire. |
REMOVAL OF THE SCREWS
| Having rigidly fixated the fracture, the
intermaxillary and intra-arch wires are removed and the MMF screws are
backed out. |
| Suturing the mucosa is only necessary when an
iatrogenic tear occurs. |
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 Maxillo
Mandibular Fixation System |
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QTY |
| 51-500-90 |
Screwdriver |
1 |
| 51-941-06 |
Teflon Container, MMF System |
1 |
| 01-002-50 |
Drill Guide, MMF System |
1 |
| 50-340-13-1 |
MMF Screw, 2.0mm x 13mm |
4 |
| 50-340-15-1 |
MMF Screw, 2.0mm x 15mm |
4 |
| 50-340-17-1 |
MMF Screw, 2.0mm x 17mm |
4 |
| 50-340-19-1 |
MMF Screw, 2.0mm x 19mm |
4 |
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