A new arch bar for oral surgery

Surgical techniques

/111 . J . Oral Surg. 1981 : 10 : 462-464 (Key words : arch bor t fl saston, intermasttksry; surgery, tJrul)

A new arch bar for oral surgery AKIRA HASEGAWA AND DONALD LEAKE Department of Oral Surgery, Nippon Dental University, Niiguta , Niigata, Japan and Department of Dentistry, Division of Ora/ Slirgery. Harbor-UCLA Medical Celller, T orrance , California, USA

AIlSTRACT - A new universal arch bar for intermaxillary fixation has been developed. This arch bar was fabricated as a wave-shaped, thin metal plate with so ldered buttons on the bucco-Iabial aspect. It is light and flexible, yet strong enough to provide excellent fixation in the treatment of fractures of the maxilla and /or mandible. It is a un iversal bar : the super ior and inferior borders arc identical. Clinical application has been broad including trauma a nd cases of orthognathic surgery.

( Re ceived for publication 9 February, accepted /9 July 1981)

Intermaxillary fixation using arch bar wiring is important in the treatment of fractures of the mandible or maxilla and for cases of orthognathic surgery . A number of prefabricated arch bars are available commercially. One of the most frequently employed in the United States is the Erich Arch Bar. On the other hand, in Japan, the Sannai, MM and 0 appliances are used. These arch bars have hook-like projections soldered to the outer aspect of the bar or fanned as an integral part of the bar for the application of tie wires or elastic hands. These hook-like projections must be o riented in an upward d irect ion for the upper jaw and in a downward direction for the lower jaw. Recently we developed a new arch ba r for intermax illary fixation, It is a universal bar made with buttons on the bueco-labial aspect instead of hooks . Thus tie wires or elastic bands can be attached from either the upper or lower aspect of the bar equally well (Fig. 1). 0300-9785/81 /0604 62-03$02.50/0

Material The arch bar is mach ined from 18-8 sta inless steel as a wave-shaped, thin metal plate. It is 0.8 mm in

Fig. I . A new arch bar with magnification of the buttons.

©

1981 Munksgaard, Copenhagen

463

ARCH BAR Unit : mm

12 8

0 .8

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B, Button B , Button

Fig. 2 . Drawing of the arch bar with bu ttons.

thickness and 128 mrn in length . The length is sufficient fo r a dental arch . Th e widest part of the arch bar is 3.5 mm and the narrowest part is 2 mrn. The steel buttons are soldered equidistantly on the buccolabial aspect of this bar. The total number of buttons is 16.The distance between the center of two buttons is 8 mm (Fig . 2). Each button is 2.5 x 3.3 mm and the heigh t is 2.0 mm (Fig. 3). Th e space on the button for the intermaxillary tie wire is 1.2 mm. The button is small and smooth so as not to damage the soft tissues. The tensile strength of the bar is 67 kgfmm'; the elongation, 22%, and the Vickers hardness of the bar is 155. The bond strength of the button at the soldered joint is about 50 kg/mm'. The mechanica l properties are qui te sufficient for intermaxil lary fixation .

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1.0 2.5 3 .3

Results and discussion Some clinical examples will demonstrate the use of this arch bar . The bar is light, flexible, and relatively soft so that it can be molded and adapted to the denta l arch. The arch bar is bent to the correct shape and ligated to the teeth by 0.5 mm diameter soft stainless steel wire ligat ures around the cervix of each available toot h (Fig. 4). Intermaxillary fixation is obtained by placing orthodo ntic elastic bands or wires between the but tons on the upper and lower arch bars. The use of this arch bar offers several advantages:

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I Fig. 3. Drawing of the button.

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464

HASEGAWA AND LEAKE

I. It is easily adapted to fit the dental arch . There is no delay for custom laboratory procedures. 2. It provides excellent fixation throughout the entire period of immobilization. 3. The bar can be placed upside down . The application of intermaxillary tie wires or elastic bands can easily be achieved from both upper and lower aspects of the bar. 4. It does not damage the gingiva . 5. It fullfills esthetic demands. There has been broad clinical application of this arch bar, including cases of both trauma and orthognathic surgery.

Address:

Fig. 4. The arch bars ligated to the teeth.

Akira Hasegawa The First Department of Oral Surgery Nippon Dental University, Niigatu NO 8,1 , Hamaura-cho, Niigatu-shi, Niigata-ken , 951 Japan