Feel free to contact us if you need technical advise for the surgery.


Immediately after surgery the fixation units are covered with some wax.  The patient replaces the wax after brushing.  This protects the cheeks, which may be irritated by the intra oral extension of the miniplate mainly shortly after surgery because of the swelling of the soft tissues.  Cooling during 48 hours post-surgery is advised and sport activities should  be avoided for 3 days.  The patients should rince twice a day with Chorhexidine during 12 days and several times a day with sparkling water.  But most patients should be instructed not to touch the extension of the miniplate repeatedly by pressure of the tongue or fingers.   This is the main reason why during the first weeks after surgery some mobility of the anchors may occur without signs of local infection.  Because the extension is a smooth new object in the mouth, most of the patients touch it repeatedly by their tongue or fingers despite clear instructions from the surgeon or orthodontist.  Therefore orthodontists have to insist on the adverse effects and risks of loosening of the miniplates and even the need for a second surgical procedure.


All along the orthodontic treatment any small mobility of a miniplate should be cross checked with some unusual repetitive loading due to bad habits.  If intercepted in time, interruption of the repetitive loading will result in an elimination of the mobility and restoration of the stability.  To reduce the adverse effects of these intermittent forces, orthodontic loading should be started no later than 2 to 3 weeks after surgery.  Initial loading should not be higher than 100 to 150 grams.  The amount of force can progressively be increased over the first 3 months, but should never exceed 250 grams.  Moreover such high forces are not needed for optimal tooth movement or better orthopedic outcome.  Closed nickel titanium coil springs can be used to move teeth but for orthopedic treatment elastics are used.  In that case the patient is instructed to remove them for brushing and to change the elastics at least twice a day.  About 10 days after surgery the orthodontist has to give specific oral hygiene instructions how to clean the soft tissues surrounding the round bar.  A soft conventional tooth brush is advised rather than the use of an electrical tooth brush..