Jaw wiring is a medical procedure to keep the jaw closed for a period of time. Originally, it was used as the mandibular equivalent of a cast, to fix the jaw in place while a fracture healed. Today, jaws may also be wired for weight-loss purposes, to prevent the ingestion of solid food.
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Mechanism
Jaw wiring is performed by attaching orthodontic brackets to the teeth, and wrapping pliable wire either around or through the brackets. The wiring is configured to place the patient’s lower jaw in a semi-closed resting position. This permits a moderate amount of jaw movement and relatively clear speech, but inhibits the ingestion of solid foods, forcing patients to adhere to a liquid diet.
Inter-maxillary fixation
The type of jaw wiring used in patients with mandibular fractures, or those who need orthognathic surgery to correct deformed jaws, is known as inter-maxillary fixation (IMF) or maxillo-mandibular fixation (MMF). It is performed by an oral surgeon, who attaches an "arch bar" to the upper jaw and another to the lower jaw with thin wires that are threaded between and around the teeth. The arch bars completely enwrap the dental arch. The upper and lower arch bars are connected to each other with elastics, compressing the upper teeth against the lower teeth and preventing jaw movement. IMF is an invasive procedure performed under general anesthesia. Once the bones have set (usually after 8–10 weeks), the wiring is removed under local anesthesia or nitrous oxide sedation.
Orthodontic jaw wiring
The second type of jaw wiring is called orthodontic jaw wiring (OJW) or dental jaw wiring, and can be used as a treatment for obesity and compulsive overeating. In this procedure, a dentist or orthodontist attaches braces to certain teeth (typically the canines and premolars) and inserts wiring, but not elastics, between the upper and lower teeth in a figure-8 pattern. The wiring is removed periodically to allow the jaw joints to move freely, especially in the vertical direction. The procedure is not invasive and does not require anesthesia.
Unlike inter-maxillary fixation, OJW does not keep the upper and lower teeth in contact. The sole purpose of the wiring is to limit the extent to which the jaws may open. In the resting position, the teeth are parted 2–4 millimeters, with the lips lightly touching. Orthodontic jaw wiring is removed when the patient has achieved their weight loss goals.