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Posts Tagged ‘maxillomandibular fixation’

The Omnimax MMF System – Product Review

Sunday, March 13th, 2016

 

Jaw surgery has a long association with the need for maxillomandibular fixation. (MMF) Wiring the jaws together is an essential first step in many types of maxillofacial surgery. Whether it is in elective orthognathic procedures, the treatment of jaw fractures or in the reconstruction of the jaw after cancer reconstruction, the application of maxillomandibular fixation is essential. Putting the teeth together in the correct occlusion (bite) ensures that the jaw realignment/restoration surgery results in a satisfactory functional outcome.

The historic and standard approach to the application of maxillomandibular fixation is the application of arch bars to the teeth with multiple interdental wires. (usually 26 gauge) This ‘gold standard’ MMF technique has been used with various modifications for over 100 years with no real changes in the concept or technique. While unquestionably effective, it is tedious and time-consuming to apply and always involves some glove integrity violation and even skin penetration. It is by far the most despised maxillofacial techniques by all surgeons of any specialty. I have applied MMF on over 1,000 cases in my career and can do in an average 15 to 20 minutes. Those plastic surgeons with far less experience (e.g., residents and young surgeons) can easily take 45 minutes to an hour of operative time to get the bars and wires correctly applied.

In addition arch bars and interdental wires pose hygiene challenges for the patient after surgery and their high compressive forces on the teeth and gums results in significant occurrences of periodontal (gum) recession via papillary blood flow compromise.

Omnimax Maxillomandibular Fixation System Dr Barry Eppley Indianapolis Omnimax MMF System Indianapolis Dr Barry EppleyThe Omnimax MMF system (Zimmer Biomet) represents breakthrough technology and is a real game changer for getting the jaws and occlusion properly aligned. While other hybrid MMF systems have emerged in the past five years, I find that they have more limited uses with their own set of problems. (e.g., mucosal tissue overgrowth of the plates and screws and a high number of screws used per arch to name the top two)

Omnimax extended screw design Dr Barry Eppley IndianapolisThe Omnimax system overcomes these MMF issues by several design innovations. The plates have a better segmentalized design with extended screw slots and are composed of an anodized titanum, all factors which contribute to less soft tissue irritation. But the key breakthrough design feature is the EXTENDED SCREW INSERTION SLOTS. This permits the MMF plate to stand off of the soft tissues while still being stabilized to the bone. This is a brilliant innovation in screw design that is proprietary to the Omnimax MMF system. Not only does the plate no longer compress the soft tissues but the stand off feature allows intermaxillary wires to be applied without creating compressing and necrosing gingival tissues.

Omnimax MMF system in place Dr Barry Eppley IndianapolisThe Omnimax MMF system with the innovative plate standoff feature due to the screw design finally overcomes the traditional problems with hybrid plate and screw MMF approaches. It decreases the number of screws needed for application (from 14 in other systems to 8) and improves intraoral hygiene and tissue health for the patient after surgery. But of equal importance in terms of operating room efficiency it changes the application of MMF from an average 45 minutes to 15 minutes (or less) with a far less risk of glove puncture.

Omnimax MMF System kit Dr Barry Eppley IndianapolisIn my opinion the new gold standard for maxillomandibular fixation has finally arrived. The simplicity and innovative design of the Omnimax MMF system will change the perception of this basic maxillofacial technique from one of contempt to possibly even pleasure.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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