Journal Logo


Reply: Stryker SMARTLock Hybrid Maxillomandibular Fixation System: Clinical Application, Complications, and Radiographic Findings

Kendrick, Douglas E. D.D.S.; Park, Chan M. M.D., D.D.S.

Author Information
Plastic and Reconstructive Surgery: November 2016 - Volume 138 - Issue 5 - p 949e-950e
doi: 10.1097/PRS.0000000000002730
  • Free


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:

  1. Use the spacer to hold the screw holes away from the mucosal tissues.
  2. Crimp the surgical lugs on the system in slightly to protect the lip.
  3. Place orthodontic wax over the lugs to protect the lip.
  4. Avoid placing a screw in the area of any labial frenum.
  5. Use the lower profile arch bar.
  6. Use radiographs to plan screw placement and angulation.
  7. Use the least number of screws possible.
  8. 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
Oakland, Calif.


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.


Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.

Copyright © 2016 by the American Society of Plastic Surgeons