Erich Arch Bars

Open Dropdown

Preoperative Considerations


  • Need for prolonged MMF
  • Weight loss
  • Tooth damage and decay
  • Trauma to soft tissues


  • Open airway or nasal tube
  • Alternatively can place arch bars with oral tube and then place into MMF after extubated


  • None


  • Local anesthesia
  • Minnesota or other cheek retractor
  • Self retaining cheek retractor
  • 24g wire cut into ~5cm pieces
  • Wire driver
  • Wire cutter
  • Wax
  • Elastics or 24g Wire Loops "People Wires"


Postoperative Considerations


  • Reinforce liquid diet

Follow Up:

  • Tighten wires PRN

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

Local anesthesia was infiltrated around all quadrants. Arch segments were digitally reduced and an Erich arch bar was adapted to the maxilla and trimmed. It was secured to maxillary teeth in a sequential fashion with 24g wire. An arch bar was then secured to the mandible in a similar fashion. The posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. The patient was then placed into maxillomandibular fixation via 24g wires. All excess wires were then trimmed. Dental wax was placed over sharp metallic surfaces for comfort.

The patient's face was then cleaned. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • 21440 Closed treatment of alveolar ridge fractures
  • D7620- Maxilla- closed reduction (teeth immobilized if present)
  • D7640-Mandible- closed reduction (teeth immobilized if present)
  • D7771- Alveolus, closed reduction stabilization of teeth
  • 21453/D7640 Closed treatment of mandible fracture with interdental fixation
  • 21421/D7620 Closed treatment of maxilla or palate with interdental fixation