We thank the authors for their interest in our article1 and for their kind words. We were lucky to have been one of the first groups to publish on the use of the Stryker SMARTLock (Stryker, Inc., Kalamazoo, Mich.) system and the first group to evaluate the screw position using cone-beam computed tomography technology.
We would agree, anecdotally, that we had improved results and fewer side effects as we became more familiar with the device, instrumentation, and placement. The following are a few things we do to decrease mucosal irrigation, lip irritation, and tooth damage:
- Use the spacer to hold the screw holes away from the mucosal tissues.
- Crimp the surgical lugs on the system in slightly to protect the lip.
- Place orthodontic wax over the lugs to protect the lip.
- Avoid placing a screw in the area of any labial frenum.
- Use the lower profile arch bar.
- Use radiographs to plan screw placement and angulation.
- Use the least number of screws possible.
- Cut off any screw holes that were not used.
The original gold color SMARTLock system had large lugs, which were too prominent. We believe this led to increased lip irritation. We were happy to see the new, low-profile system, which is silver in color. We have found that even though this system is smaller in all dimensions, it is still very rigid when the screws are placed. It appears that the patients have tolerated the low-profile system better and with less irritation. We thank the authors for their comments, and they are free to contact us with any additional comments.
The authors have no financial interest to declare in relation to the products or devices mentioned in this communication. They have no financial interest in the Stryker Corporation or any of the products supplied by the company.
Douglas E. Kendrick, D.D.S.
University of Iowa Health Care
Oral and Maxillofacial Surgery
Iowa City, IA
Chan M. Park, M.D., D.D.S.
Division of Oral and Maxillofacial Surgery
Alameda Health System, Highland Hospital
1. Kendrick DE, Park CM, Fa JM, Barber JS, Indresano AT. Stryker SMARTLock hybrid maxillomandibular fixation system: Clinical application, complications, and radiographic findings. Plast Reconstr Surg. 2016;137:142e150e.
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