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Indian Journal of Plastic Surgery
Medknow Publications on behalf of Indian Journal of Plastic Surgery
ISSN: 0970-0358 EISSN: 1998-376x
Vol. 44, Num. 1, 2011, pp. 160

Indian Journal of Plastic Surgery, Vol. 44, No. 1, January-April, 2011, pp. 160

Letter to Editor

The use of bone wax for protection from sharp ends of interdental wires

Özgür Pilanci1, Kerstin M Stenson2, Samet Vasfi Kuvat3

1 Department of Plastic and Reconstructive Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
2 Department of Otolaryngology, University of Chicago Medical Center, Chicago, USA
3 Istanbul Medical Faculty, Istanbul, Turkey

Correspondence Address:
Özgür Pilanci
Eski Londra Asfalti Emlak Konut Sitesi, B2, Blok D:13, Bahcelievler - Istanbul
Turkey
ozgurpilanci@yahoo.com


Code Number: pl11034

DOI: 10.4103/0970-0358.81462

Sir,

Mechanical irritation interdental loop wiring and intermaxillary fixation causes inflammation of oral mucosa, marginal gingiva and lips is virtually unavoidable in maxillofacial surgery. [1] Filippi et al. compared different types of splints (composite wire splinting, button bracket splinting, resine splinting and titanium trauma splinting) by means of irritation on gingival mucosa and lips. In their experimental study, they found that more irritation was caused by buton bracket splints on lips and by resine splint on gingival mucosa. [2]

We thought of using bone wax in order to cover the protrusive components of wires [Figure - 1]. In this way, we aimed to attenuate the mechanical irritation of intraoral mucosa and gingiva. Furthermore, it is obvious that this will also improve oral hygiene.

Bone wax, which is made of softened beeswax, has been widely used for haemostasis in orthopaedic surgery, neurosurgery, cranio-facial surgery and cardiothorasic surgery. [3],[4] Rarely bone wax causes side effects, some of which are inhibition of bone healing, increased infection rates and chronic inflammatory reactions. [4],[5] These side effects are observed in the in vivo utilisation of bone wax. Besides, we did not encounter reports on the external use of bone wax, such as in covering the protrusive components of wires, in the literature.

Repetitous use of bone wax during splintig may be regarded as a drawback. On the other hand, it is a low-cost material that could be easily obtained and applied by the patients whenever necessary.

We recommend the use of bone wax as it is a practical and efficacious method to prevent mucosal injury from wires.

References

1.Lello JL, Lello GE. The effect of interdental continuous loop wire splinting and intermaxillary fixation on the marginal gingiva. Int J Oral Maxillofac Surg 1988;17:249-52.  Back to cited text no. 1  [PUBMED]  
2.Filippi A, von Arx T, Lussi A. Comfort and discomfort of dental trauma splints-a comparison of new device (TTS) with three commonly used splinting techniques. Dent Traumatol 2002;18:275-80.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Prziborowski J, Hartrumpf M, Stock UA, Kuehnel RU, Albes JM. Is bone wax safe and does it help? Ann Thorac Surg 2008;85:1002-6.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Wellisz T, Armstrong JK, Cambridge J, An YH, Wen X, Kang Q, et al. The effects of a soluable polymer and bone wax on sternal healing in an animal model. Ann Thorac Surg 2008;85:1776-80.   Back to cited text no. 4    
5.Angelini GD, el-Ghamari FA, Butchart EG. Poststernotomy pseudo-arthrosis due to foreign body reaction to bone wax. Eur J Cardiothorac Surg 1987;1:129-30.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]

Copyright 2011 - Indian Journal of Plastic Surgery

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