IMPLEMENTATION OF AN OCCLUSAL WAFER IN SEVERE MANDIBULAR FRACTURE CASES WITH POST-ORIF MALOCCLUSION: A CASE SERIES
Improper treatment of severe mandibular fractures can often lead to malocclusion, creating significant challenges for reconstructive surgeons. To address this, the occlusal wafer offers an effective solution for managing malocclusion following open reduction and internal fixation (ORIF) plating of maxillofacial fractures, especially during the one-month postoperative evaluation period. Made from acrylic resin, the occlusal wafer serves as an intermediate guide in orthognathic surgery. It assists in repositioning the maxilla, adjusting the mandible, and modifying the jawbones to achieve ideal occlusion. The device is capable of reshaping the dental arch to any pre-planned position within 2 to 4 weeks.
We present two cases of patients with segmental mandibular fractures.
Case 1: A 26-year-old male presented with segmental fractures of the left angle and right body of the mandible. After ORIF plating, the patient initially achieved occlusion. However, malocclusion developed during a three-week follow-up.
Case 2: A 28-year-old female had segmental fractures of the left angle and right body of the mandible. Similar to Case 1, the patient achieved occlusion after ORIF plating, but malocclusion was noted during a one-month follow-up.
Both patients had segmental fractures and experienced malocclusion following ORIF plating. However, the installation of the occlusal wafer successfully restored ideal occlusion for both individuals. The use of the wafer allowed for controlled realignment of the mandible and maxilla, ensuring proper bite and jaw function post-surgery.
The occlusal wafer provides an effective method for achieving optimal occlusion in patients following ORIF plating, particularly in cases where occlusal alignment remains unachieved. Its use streamlines the surgical process by reducing operating time and simplifies postoperative monitoring, making it an invaluable tool in the management of malocclusion caused by mandibular fractures.
