Restriction of Mandibular Movements Using Modified Eyelets with Hooks and Elastics

Abstract

There are various procedures mentioned in the literature for restriction of mandibular movements. Arch bars, intermaxillary fixation (IMF) screws and eyelet wiring were commonly used for achieving IMF. Arch bar placement has the disadvantage of placing minimum of 12 wires in each arch which is time consuming, chances of injury to the operators finger as well as transmission of blood borne diseases are more, damage to periodontium, discomfort due to number of wires in the mouth with difficulty in maintaining oral hygiene [1]. IMF screws have the chances of mucosal coverage over the screw and damage the roots [2]. Eyelet wiring is commonly used for the purpose with Hallams and Williams Modifications [3].The problem with eyelet wiring is in the placement of elastics over eyelet. The other techniques to reduce mouth opening through elastic placement are with the help of Erich/customized arch bars or with IMF screws. We recommend a modification (j shaped hook with eyelet) in eyelet wiring (Fig. 1) for placement of elastics (Fig. 2). Twenty four gauze wire is used after temporization for fabrication for modified eyelet with hooks. It is useful in patients (in case of condylar fractures treated with closed reduction) in whom after IMF with wires elastics are used We found our technique simple, cheap, efficient and less time consuming. Fig. 1 Modified eyelet with hook (RAI Modification) Fig. 2 Patient with modified eyelet with elastics