Enforced Intermaxillary Fixation (IMF) as a Treatment of Obesity.
Intermaxillary fixation (IMF) using metal cap splints and various linkages was tried in a group of 11 patients who had requested restriction of solid diet as a treatment for their obesity (Quetelet's index > 25-35). Compliance with treatment protocols was successfully addressed by means of support from physicians, dietitians, clinical psychologists and by peer groups. Non-compliance was defined and agreed. The full cap splints for each dental arch, linked and enforced by special rigid locking devices, proved to be a reliable technique of IMF for periods of up to 3 months. Thereafter, the majority of the patients attempted interference with the IMF linkage or detached the splints. Eight patients gained weight after removal of the IMF. Two patients were successful in weight stabilization after 2-14 kg weight loss during IMF. It is probable that psychological and personal factors contributed to their success. It was concluded that by Itself, rigidly enforced IMF for 3 months or longer was an unsuitable treatment mode for the majority of obese patients but could be used as a preparation for other forms of bariatric surgery.
Cannell
H
Department of Oral and Maxillo-Facial Surgery, The London Hospital Medical College, University of London, London, E1 2AD UK.