Tigerstedt wire splint (jaw clamp): smooth, with hook loops

The first who came close to a detailed study of recovery methods after shrapnel wounds with broken jaw, was the dentist Severin Tigerstedt. His developments helped to restore the functionality of the jaw apparatus to many people, not only during military operations, but also in civilian life.

Subsequently, his designs were improved and modernized. Due to their simplicity and low cost, Tigerstedt wire tires are still used today.

Feature of the technique

There are several methods for applying wire ligatures according to Ivy, Geikin and others. However, immobilization of jaw fragments using splints is considered a more rational method compared to ligature ligation, which is only a temporary procedure and is combined with the imposition of the chin sling.

The Tigerstedt fixation method is considered universal, since it is used for almost all fractures of the jaw bones. For manufacturing, a wire made of aluminum with a cross section of up to 2.0 millimeters is used.

The natural softness of aluminum makes it possible to manufacture structures by hand. At the same time, no complicated instrumentation is required, due to which the retainer is adjusted for each patient and is used in any conditions.

This technique was modernized by Russian scientists A.A. Limberg and A.E. Rauer.

Varieties of Tigerstedt tires

Practicing dentists use five types of jaw retainers according to the Tigerstedt method.

Smooth brace bar

It is used in case of a fracture of the lower jaw, if 4 teeth are preserved (on a large breakaway). Splinting with a smooth brace is performed in the following cases:

• when the linear occurred lower jaw fracture;
• in order to prevent fracture when performing cystostomy, cystectomy or resection;
• when cracks occur.

Fastening is done with aluminum wire. It is bent in an arc, making it hook on wisdom tooth, after which each dental unit is covered. At the end of the manipulation, the ligatures (distal and medial ends) are twisted. The ends of the cut ligatures are placed in the intervals between crowns.

This orthopedic product is removed after 5 weeks.

With spacer

A wire splint with a spacer is placed if the crowns are not preserved in the area of ​​the injury, and the fracture itself passes along the alveolar part. A feature of this tire is the location of the spacer in the fracture site.

To prevent displacement, the edges of the bend are positioned with an emphasis on adjacent teeth.

With hook loops

A tire with hooking loops is produced at an angle of 90 or 45 degrees.

This method allows you to eliminate a fracture of the lower jaw with and without displacement. If the integrity of the upper jaw is violated, it becomes necessary to wear bandages (sling-shaped).

Five or six loops are made on the bus, the length of which is from 3 to 4 mm. They are placed on even dental units. The hooks are fitted with rubber tubes, which are changed every six days. Ligatures are tightened periodically with an interval of 2 days.

With an inclined surface

A tire with an inclined surface is used if it becomes necessary to prevent lateral displacement to the fracture site. The supporting inclined plane is vertically installed hinges, which are twice the height molars.

With reference plane

An orthopedic product with a holding (support) plane prevents sagging of tissues and flaps of the hard palate. Therefore, when installing this type of product, there is a positive dynamics of the healing process in case of traumatic damage to the bones of the upper jaw or after operable therapy on it.

General rules and basic provisions for the imposition of structures

The imposition of orthopedic structures, regardless of their type, occurs in compliance with the following rules:

• the manipulation is carried out after the introduction of local anesthetics;
• subcutaneous injection of Atropine is performed to reduce the production of saliva;
• the structure begins to bend from the left side;
• the structure is bent outside the oral cavity;
• by medical agreement, the ligature wire is twisted only clockwise.

The main criteria that indicate that the orthopedic construction is installed correctly:

• has an arrangement on the neck;
• touches each tooth (at least at one point);
• repeats the outlines of the dentition;
• does not spring;
• despite contact with the papillae, they are not injured.

In recent years, dental practitioners have preferred operable methods over wire mobilization in the treatment of mandibular fractures. This is due to the fact that the recovery process is shortened, and, as a consequence, the time spent by the patient in the hospital decreases.

Another benefit of operable therapy is that it makes dental care easier. It is also important that the patient's nutrition does not cause any particular difficulties.