Circumdental wiring is sometimes useful for provisional fracture reduction.
Apply arch bars to the mandible and maxilla. Sometimes, not every wire in those teeth adjacent to the fracture has to be fully tightened before manual fracture reduction is accomplished.
Apply the intermaxillary ligatures to maintain the occlusal position.
The patient is usually maintained in MMF no more than 6 weeks.
Pearl: individual laboratory designed arch bars
After taking impressions individual arch bars can be fabricated on dental casts. Prior to the arch bar fabrication, these casts are sectioned and the fracture is reduced (see blue zone on the cast). Thus, the arch bar helps in the reduction. Furthermore, individual arch bars prevent damage of the periodontal soft tissues and are less invasive.
Clinical image shows the preshaped arch bar before applying MMF.