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  • Writer's pictureInvisian Medical

The Minne Skinny Q2 2024



 

In this Newsletter

1) A New Patient Case Report

2) Details on the MT-1003 Discontinuation

3) Recent Events and updates


 

 Patient Case Report

Minne Ties as a Bridle Wire for a Palate Fracture and IMF During LeFort Fixation


A 51-year-old previously healthy female with good oral hygiene and class I premorbid occlusion presented to the University of Pittsburgh Medical Center (UPMC) Mercy Hospital Emergency Department following a fall from a slide into a table, striking her midface. Physical exam showed right maxillary occlusal step off between teeth #6 and 7, gross maxillary mobility on manual palpation, and anterior open bite. CT Maxillofacial showed open LeFort I, right hard palate, and nasal bone fractures. The patient lived out of state, rendering Erich or hybrid arch bars or a palatal splint technically difficult to remove. Minne Ties applied as a bridle wire presented a hygienic alternative that would be straightforward for the general dentist or oral surgeon to remove in the office under local or topical anesthesia. Risks, benefits, and alternatives were discussed, and the patient subsequently consented to open reduction and internal fixation of LeFort I and palatal fractures, and closed reduction of nasal bone fractures under general anesthesia.



Pre-op Coronal Pre-op axial


After induction of general anesthesia, the patient was prepped and draped with exposure to the head and neck. A maxillary vestibular incision was used to expose the anterior maxilla, and all fractures were debrided of granulation tissue. Three Minne Ties were applied in the embrasures between the molars and premolars bilaterally, from posterior to anterior and beginning on the right side. Three large (1.0 mm) Ties were placed on each side and easily passed through the embrasures using the rigid, blunt tip introducer, and then through the self-locking clasp to form a loop with each Tie. One medium (0.7 mm) Tie was passed through the embrasures of teeth #6 through 8 using the rigid, blunt tip introducer, and then through the self-locking clasp to form a loop to reduce the right palate fracture, in a bridle wire fashion. The bridle wire was tightened first to reduce the palatal fracture at the level of the dentition.




Intra-op IMF Intra-op fixation


Next, the Minne Ties were tightened from anterior to posterior to achieve premorbid occlusion. Final tightening was performed to ensure strong and stable MMF and occlusion. Fixation of the LeFort I fracture ensued at the piriform rims and zygomatic buttresses using 0.7 mm midface plates with monocortical fixation using two to three screws on either side of the fracture. Lastly, one 0.7mm midface plate was adapted across the palatal fracture between teeth #7-8 to consolidate the segments. The patient was released from intermaxillary fixation and the desired class I occlusion was confirmed. The bridle wire was left in place for the reduction of the palatal fracture.



Immediate Post-op occlusion Post-op axial


Total procedure time was approximately 75 minutes. Adequate occlusion following Minne Ties application was demonstrated clinically and with postoperative CT. After several weeks, the Minne Ties bridle wire was removed in clinic using a heavy wire cutter without administration of sedation or local anesthetic. The patient tolerated the Minne Tie well and endorsed premorbid occlusion at the time of removal. The patient reported the Minne Tie being comfortable, and was able to maintain meticulous hygiene around the device. The accepting surgeon was able to remove the device in his office without needing to administer local anesthesia or acquire additional armamentarium. Minne Ties Agile MMF are impressive in their ability to achieve both patient satisfaction and provider satisfaction as a minimally cumbersome, sufficiently strong, and efficient option for closed reduction of palatal fractures. This case highlights the utility of Minne Ties in a bridle wire technique, with improved post-operative hygiene and easy removal in the office. Given the positive outcome, this case represents the first of what will eventually become broader utilization of Minne Ties for appropriate patients in the clinic, ED and OR at UPMC.


 

Important Update:

Discontinuation of the MT-1003s


In response to surgeon feedback and limited utilization over the past few years, the “Small” size Minne Ties (0.5mm) have been discontinued. The product code MT-1003 containing two 0.5mm Ties is no longer available for purchase. Utilization of the 1.0mm and 0.7mm sizes has fully met the clinical needs of surgeons, which supported this decision.


The 0.7mm Ties (included in the MT-1000 12-pack and MT-1002 two-pack) are appropriate for small/tight embrasures where the 0.5mm may have been considered. However, the 0.7mm size offers significantly enhanced strength with only slight dimensional differences.

We always recommend beginning with application of the solid green 1.0mm Tie, which is found in the MT-1000 and MT-1001 packaging configurations. This minimizes the chance of the Tie "flossing out" (i.e. pulling through the contact point). Only drop down to the striped 0.7mm Tie if the solid green 1.0mm doesn't fit in the embrasure.

Please contact our customer service team with any questions related to this update at customerservice@minneties.com.



 

Recent Events


Invisian Medical was happy to support the AACMFS 2024 Annual Scientific Meeting from April 3-6 in Nova Scotia, Canada. We hope to see everyone again next year!


Invisian Medical is also pleased to have recently hosted training events at the following programs


Rutgers School of Dental Medicine OMFS Residency

SUNY Upstate Medical University Otolaryngology Residency

We are excited to welcome Atrium Health and Banner Health to the Minne Ties family!


As with most surgical procedures, there are risks associated with maxillomandibular fixation (MMF), including with Minne Ties. For complete information regarding indications for use, additional application and removal instructions, risks, contraindications, warnings, precautions and adverse events, please review the device’s Instructions for Use (IFU) included in the package and at www.minneties.com.


© Copyright Invisian Medical 2024 MT-2024-007-REV 0

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