Resources to ensure that Minne Ties are correctly applied to the patient
Use the Largest Size Possible
Use the largest size Minne Ties whenever possible, which minimizes the chance of "flossing out" (i.e. the Ties can pull through the contact point). Only drop down to a smaller size if the largest size won't fit in the embrasure. In this image, the circled Minne Tie would have ideally been the larger size.
Use 3-4 Ties per Side
It is recommended to use 6-8 ties total for the best strength of construct; Minne Ties are designed to work as a system. Ideally place the ties in sequential embrasures, which creates a buttressing effect. This reinforces the overall strength of construct.
First, tighten each of the Minne Ties finger tight. If the tissue is pierced during insertion, be sure to pull the suture through that tissue down to the contact point of the teeth. Lastly, while holding the clasp against the teeth, pull straight out on the suture with a needle driver. Make sure the Minne Ties are fully seated at the contact points (see image).
Initial Patient Selection
Tutorial Video (2:36)
Standard Application Tips
Make a plan – assess embrasure alignment
Always try the 1.0 mm size first. If it will not fit use the .7 mm size
Insert introducer back out of the mandibular embrasure from lingual to buccal
Place the introducer into the green side of the clasp head
Pull on the suture to tighten, not on the metal introducer
Tighten all sutures 'finger tight'. Double check occlusion
Tighten again to remove any "slack" by holding clasp against teeth with a pickle fork or needle driver and pulling perpendicularly out on the suture
Begin posteriorly, moving anteriorly as you place ties
Insert introducer into the maxillary embrasure, from buccal to lingual
Leave the tie loose until all sutures have been placed
Apply 4 per side, using adjacent embrasures when possible
Make sure Ties are fully seated at the contact points (pulled through any tissue)
Use suture scissors or scalpel to cut the tail of the suture
Cut suture to remove in the OR, ED, or clinic
Alternative Application Techniques
It is sometimes beneficial to place Minne Ties in a figure 8 formation for temporary MMF. This can be done by inserting the introducer into the maxillary embrasure and leaving a half inch tail at the clasp end to secure during the last step. Loop horizontally and exit the lingual embrasure, then cross diagonally to reinsert into the mandible buccal embrasure. Loop horizontally again and insert the introducer into the clasp head.
Physicians can reduce a mandible fracture prior to plating by applying Minne Ties horizontally around a few adjacent teeth, straddling the fracture. The best practice is to use the Minne Ties bridle wire style application in conjunction with vertical Minne Ties applied sequentially, as the strength of Minne Ties comes from their use as a system. This technique is comparable to applying a bridle wire for fracture reduction.
Two Minne Ties can share an embrasure when the standard application isn't possible due to inadequate dentition. Best practice is to form a "triangle" by applying Minne Ties in two separate embrasures on the maxilla or mandible and by sharing one embrasure on the opposite site.