Securing Fixed Orthodontic Components With Vinyl Polysiloxane for Ease During Orthognathic Surgery

Abstract

Unease from brackets, archwires, and ligature ties during orthognathic surgery makes oral and maxillofacial surgeons to distract from their work field, which in turn makes precise maneuvering and fixation of the jaws challenging. The present article describes a simple, useful clinical tip which eliminates the above problem by covering the fixed orthodontic components using vinyl polysiloxane impression material (putty).

Introduction

Orthognathic surgery demands skillful task and effort from the surgeons. However, they often experience uneasiness (gloved fingers get caught) from brackets, archwires, and ligature ties (Figure 1), when they manipulate the jaws for precise positioning. The situation might be trivial; yet, it detracts their attention and composure. The present clinical tip describes a simple, effective method that eliminates this problem by covering the fixed orthodontic components using vinyl polysiloxane impression material (putty).

Procedure

Take one scoop of catalyst and one scoop of a base of vinyl polysiloxane (putty) and mix them to get a uniform color as per the manufacturer’s instructions. Make it into a rope of approximately 1 cm in width (height of the brackets) and a length sufficient to cover the brackets from molar to molar (intra-arch). Clean and dry the brackets, archwire, and their adjacent areas with a 3-way syringe. Before the putty is set, place it along the archwire and brackets and adapt it using fingers without involving the hooks. Once the putty is set, cut the excess with No. 15 Bard-Parker (B.P.) blade (Figure 2). The same procedure is to be repeated on the other arch. The hooks can be used for maxillomandibular fixation (Figure 3) and help in post-operative elastic traction. Once the purpose is solved, the putty can be easily removed from the fixed appliance components using a straight probe or an explorer.

Figure 1.

Source: Department of Orthodontics, GSL Dental College & Hospital.

Advantages

• A hassle-free orthognathic surgery can be performed with the orthodontic appliances intact.

• Vinyl polysiloxane impression material (putty) is easy to manipulate, adapt, and has a high tear strength. ¹

• It does not easily dislodge during maxillomandibular fixation.

• It can be easily removed as a rope from the fixed orthodontic components once the purpose is solved.

Conclusion

The present clinical tip aims to eliminate the discomfort caused by the orthodontic components during orthognathic surgeries by placing vinyl polysiloxane impression material (putty).

Figure 2.

Source: Department of Orthodontics, GSL Dental College & Hospital.

Figure 3.

Source: Department of Orthodontics, GSL Dental College & Hospital.