A new type of occlusal wafer for orthognathic surgery.

Occlusal wafers are commonly used to establish the intermediate and final position of the occlusion during orthognathic operations. Various problems have been experienced in the construction of these wafers. Acrylic wafers have poor compressive and tensile characteristics, take time to make, and are bulky. They can also distort while curing, increasing the risk of inaccurate localization of the jaws during operation. To improve the speed of acrylic wafer preparation, self-cured acrylic resin is often used, but monomer leach may irritate soft tissues. In addition, strength has been improved by using carbon fibres.1 Alternatively a clear silicone wafer has been recommended which reduces the time taken to make the wafers and the overall cost. Nevertheless, this material may be too flexible to permit accurate positioning of the jaws.2 Problems may be encountered in stabilizing an acrylic wafer during orthognathic operations while the maxilla and mandible are being repositioned. Previously scalloped labio-buccal extensions to the wafer, which are perforated, have been used to wire the wafer to the orthodontic brackets. However, the wafer is cumbersome and both the construction in the laboratory and the placement in theatre are time-consuming. To overcome these problems of labour intensity, dimensional stability and occlusal accuracy, a new technique for making wafers has been developed using lightcured acrylic resin (Traid Trans Sheet, Trubyte Dentsply). To stabilize the wafer during operation, orthodontic elastic power chain is incorporated into the wafer.