Interdental wires (embrasure)

Interdental wires (embrasure) are the simplest and fastest form of MMF to implement.

They may be used for simple mandibular fractures in patients with good dentition.

Because of the wires' large gauge, caution must be used when any of the teeth are loose.

One pitfall when using arch bars is the risk of stick injuries. Passing the wires to secure the arch bar can result in a puncture or tear in the surgeon's glove and the possibility of disease transmission to the surgeon.

Universal infection control must be ensured for every patient, regardless of the disease status of the patient. Adequate protective barriers, as well as techniques, are essential to prevent stick injuries.

The use of double gloves provides a second protective barrier. The lower number of perforations in the inner gloves demonstrates the effectiveness of double gloving.

Consider changing gloves in the following circumstances:

• When the outer glove is torn
• When wetting is seen beneath the outer glove
• Every 120 minutes
• After every arch

The following techniques may help to prevent stick injuries:

• Whenever possible, implement MMF in a surgical setting with an assistant
• Handle sharps carefully
• Try to use a “non-touch technique” with wires, grasping the wires with wire twisters only and not touching them with fingers
• Always grasp loose ends at the tip to avoid leaving a wire tip “open”.
• Discard cut wire pieces in a sharps container

A thicker gauge wire (eg, 0.64 mm) is passed through the interdental spaces between the maxillary and mandibular teeth. A minimum of one wire on each side of the mandible should be used.

When all the wires have been passed, they are tightened with the patient in occlusion.

ORIF is then performed, and the wires are removed at the end of the case.

Due to the difficulty of removing these large wires, it is not recommended to leave them in postoperatively.