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Back to the OJW protocol as demonstrated by the case of NM
Methods and Instruments to remove the wires used to hold the jaws apart in OJW:
The protocol for OJW requires that under ideal conditions the patients jaws remain wired apart in "Rothstein's OJW position of rest" for 5 weeks and then the wires are removed for at least 5 days, and 3-5 days additional if the jaw felt in the least bit stiff. During the 5 days the wires were off the patient is ordered to exercise the jaws: using manual exercises or just talking, singing and chewing gum. In that way the joint if impaired would fully recover.
In only one case out of 65 did any stiffness occur in any of my OJW patients. Read A.T.'s Story She left the wires on for 12 weeks straight at the end of which time she was unable to place three fingers vertically in her mouth. (This is the norm that dentists use to test the extent of mouth opening (see photo below). At the end of the twelve weeks she was unable to open her mouth more than two fingers. She recovered full mobility in a short time.
The three finger test: patient places his/her three fingers in his/her mouth as shown above.
In all cases the OJW patient is instructed to remove the wiring at least 5 days before returning to the OJW provider's office. (S)he will check the patient's gums, teeth, and jaw mobility. If the jaws are have retained their normal mobility in all directions (open and closed, right and left, forward and backward). Range of Motion Goals:40 mm or greater vertical opening: (see photo just above).
6-8 mm protrusion: the distance you can
make your jaw jut forward.
the provider will clean the teeth (inside and out) and rewire the jaws apart in "Rothstein's OJW position of rest"
All patients are provided with two instruments at the
1. An instrument to twist (and untwist the wires). and
2. A wire cutter.
The third "instrument" they are informed of is a simple fork whose tines are not pointy sharp.
The pictures below demonstrate the use of these tools to untie/remove the ligature wires.
This instrument is used to untwist the ends that were created when the jaws were wired apart. One of the loose end is held and unwrapped off the bracket. The wire cutter is the recommended instrument to remove the jaw wiring. The patient simply nips open the wire and lifts off the wire.
If a situation were to arise that demanded instant removal of the wiring and the patient left their wire cutter behind, a fork inserted between the wire and the tooth would forcibly cause the bracket to detach immediately allowing the wire to be lifted off the other brackets.
A close up showing the utility of a fork to forcibly cause the bracket to detach.
This a nail and cuticle scissor. I had no problem cutting the wire I like this one the best of all. It supplants the wire nipper by far and away. This is the LA CROSS cuticle trimmer #75920.Costs $3.99. I tested this and it nipped the wire open with ease. It looks good and has multiple purposes.
August 15, 2007