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Craniomaxillofac. Trauma Reconstr., Volume 18, Issue 3 (September 2025) – 4 articles

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46 pages, 6649 KiB

Open AccessReview

Matrix Wave^TM System for Mandibulo-Maxillary Fixation—Just Another Variation on the MMF Theme?—Part II: In Context to Self-Made Hybrid Erich Arch Bars and Commercial Hybrid MMF Systems—Literature Review and Analysis of Design Features

by Carl-Peter Cornelius, Paris Georgios Liokatis, Timothy Doerr, Damir Matic, Stefano Fusetti, Michael Rasse, Nils Claudius Gellrich, Max Heiland, Warren Schubert and Daniel Buchbinder

Craniomaxillofac. Trauma Reconstr. 2025, 18(3), 33; https://doi.org/10.3390/cmtr18030033 - 15 Jul 2025

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Abstract

Study design: Trends in the utilization of Mandibulo-Maxillary Fixation (MMF) are shifting nowadays from tooth-borne devices over specialized screws to hybrid MMF devices. Hybrid MMF devices come in self-made Erich arch bar modifications and commercial hybrid MMF systems (CHMMFSs). Objective: We survey the available technical/clinical data. Hypothetically, the risk of tooth root damage by transalveolar screws is diminished by a targeting function of the screw holes/slots. Methods: We utilize a literature review and graphic displays to disclose parallels and dissimilarities in design and functionality with an in-depth look at the targeting properties. Results: Self-made hybrid arch bars have limitations to meet low-risk interradicular screw insertion sites. Technical/clinical information on CHMMFSs is unevenly distributed in favor of the SMARTLock System: positive outcome variables are increased speed of application/removal, the possibility to eliminate wiring and stick injuries and screw fixation with standoff of the embodiment along the attached gingiva. Inferred from the SMARTLock System, all four CHMMFs possess potential to effectively prevent tooth root injuries but are subject to their design features and targeting with the screw-receiving holes. The height profile and geometry shape of a CHMMFS may restrict three-dimensional spatial orientation and reach during placement. To bridge between interradicular spaces and tooth equators, where hooks or tie-up-cleats for intermaxillary cerclages should be ideally positioned under biomechanical aspects, can be problematic. The movability of their screw-receiving holes according to all six degrees of freedom differs. Conclusion: CHMMFSs allow simple immobilization of facial fractures involving dental occlusion. The performance in avoiding tooth root damage is a matter of design subtleties. Full article

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28 pages, 12965 KiB

Open AccessReview

Matrix Wave^TM System for Mandibulo-Maxillary Fixation—Just Another Variation on the MMF Theme? Part I: A Review on the Provenance, Evolution and Properties of the System

Craniomaxillofac. Trauma Reconstr. 2025, 18(3), 32; https://doi.org/10.3390/cmtr18030032 - 12 Jul 2025

Cited by 1 | Viewed by 156

Abstract

Study design: The advent of the Matrix Wave^TM System (Depuy-Synthes)—a bone-anchored Mandibulo-Maxillary Fixation (MMF) System—merits closer consideration because of its peculiarities. Objective: This study alludes to two preliminary stages in the evolution of the Matrix Wave^TM MMF System and details its technical and functional features. Results: The Matrix Wave^TM System (MWS) is characterized by a smoothed square-shaped Titanium rod profile with a flexible undulating geometry distinct from the flat plate framework in Erich arch bars. Single MWS segments are Omega-shaped and carry a tie-up cleat for interarch linkage to the opposite jaw. The ends at the throughs of each MWS segment are equipped with threaded screw holes to receive locking screws for attachment to underlying mandibular or maxillary bone. An MWS can be partitioned into segments of various length from single Omega-shaped elements over incremental chains of interconnected units up to a horseshoe-shaped bracing of the dental arches. The sinus wave design of each segment allows for stretch, compression and torque movements. So, the entire MWS device can conform to distinctive spatial anatomic relationships. Displaced fragments can be reduced by in-situ-bending of the screw-fixated MWS/Omega segments to obtain accurate realignment of the jaw fragments for the best possible occlusion. Conclusion: The Matrix Wave^TM MMF System is an easy-to-apply modular MMF system that can be assembled according to individual demands. Its versatility allows to address most facial fracture scenarios in adults. The option of “omnidirectional” in-situ-bending provides a distinctive feature not found in alternate MMF solutions. Full article

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16 pages, 1458 KiB

Open AccessSystematic Review

Optimal Duration of Antibiotic Therapy for Space Infections in the Maxillofacial Region: A Systematic Review

by Abdullah Saleh Alhudaithi, Faris Jaser Almutairi, Abdullah Saleh Almansour, Abdurrahman Abdurrazzaq Aljeadi and Shaul Hameed Kolarkodi

Craniomaxillofac. Trauma Reconstr. 2025, 18(3), 31; https://doi.org/10.3390/cmtr18030031 - 3 Jul 2025

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Abstract

Objective: This review aimed to examine and highlight the treatment protocols and optimal duration of antibiotic regimens used in managing maxillofacial space infections of odontogenic origin, along with the associated clinical outcomes. Materials and methods: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD42024621000). A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies from January 2003 to October 2024 using relevant MeSH terms. Studies were selected based on PEO criteria, focusing on the antibiotic treatment protocols and duration for odontogenic maxillofacial space infections, with inclusion of original human research and exclusion of non-relevant or unclear studies. Two independent reviewers performed study selection, data extraction, and risk of bias assessments using the Cochrane RoB 2 and ROBINS-I tools, resolving disagreements through discussion. Results: After data extraction, 277 papers were initially identified. Following the removal of duplicates, 141 articles were screened, of which 64 were selected for full-text assessment and 55 were excluded with justification. Ultimately, nine studies met the inclusion criteria for this review. These included two prospective double-blinded randomized clinical trials (RCTs), two prospective RCTs, four retrospective studies, and one prospective study, all involving patients with dentoalveolar orofacial infections. Risk of bias (RoB) assessment using RoB 2 indicated that two RCTs had a high risk of bias, one had a low risk, and one raised some concerns. ROBINS-I assessment showed moderate risk of bias in three studies, while two were not evaluated. Conclusion: This review concludes that prompt incision and drainage combined with a short-course antibiotic regimen of two to five days is generally effective for managing odontogenic maxillofacial space infections, though further high-quality randomized trials are needed to standardize treatment protocols. Full article

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15 pages, 591 KiB

Open AccessArticle

Factors Influencing Mandibular Invasion, Lymph Node Metastasis and Extracapsular Spread in Squamous Cell Carcinoma of the Oral Cavity

by Rathindra Nath Bera and Richik Tripathi

Craniomaxillofac. Trauma Reconstr. 2025, 18(3), 30; https://doi.org/10.3390/cmtr18030030 - 27 Jun 2025

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Abstract

Background: A number of factors might affect survival in oral squamous cell carcinoma. Nodal status is one of the most important prognosticators affecting survival. Studies have shown that pattern of invasion is an important aspect related to survival. Study design: retrospective single-center study (original article). Objectives: Our study aimed at evaluating the factors affecting mandibular invasion, lymph node metastasis, and extracapsular spread in oral squamous cell carcinoma and the survival factors associated with it. Methods: Patient records were evaluated to identify factors influencing primary outcome and survival. Cox regression analysis and Kaplan Meir were applied to evaluate the outcomes. Youden’s index was used to determine a cut-off value for depth of invasion and lymph node size affecting outcome. A p value of <0.05 was considered statistically significant. Results: The study evaluated 162 patients with oral cancer. The cut-off value for DOI was 6.5 mm, significantly affecting mandibular invasion and cervical metastasis. The cut-off value for lymph node size was 2.95 cm, significantly affecting extracapsular spread and overall survival. An aggressive pattern of invasion significantly affects mandibular invasion, cervical metastasis, and survival. Conclusion: An aggressive pattern of invasion and depth of invasion are independent risk factors for cervical lymph node metastasis and mandibular invasion. The independent risk factor for extracapsular spread is lymph node size. Lymph node metastasis and nodal size, pattern of invasion, mandibular invasion, and extracapsular spread are independent risk factors affecting overall survival. Full article

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