matrixorthognathic plating systemsynthes.vo.llnwd.net/o16/llnwmb8/us mobile/synthes north... ·...
TRANSCRIPT
surgICal TeChnIquesurgICal TeChnIque
maTrIxorThognaThICTm PlaTIng sysTem Specialized implants and instruments for orthognathic surgery
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF
Table of ConTenTs
InTroduCTIon
surgICal TeChnIque
ProduCT InformaTIon
referenCes
matrixorThognaThICTm Plating system 2
features and benefits 4 matrixorThognaThICTm Plate and screw Color‑Coding 6
ao Principles 7
Indications 8
lefort I fixation 9
sagittal split fixation 12
sagittal split fixation with adjustable slider (optional) 15
genioplasty fixation 20
Implants 22
Instruments 26
modules and accessories 30
matrixorThognaThIC Plating system 32 references 36
2 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
maTrIxorThognaThIC PlaTIng sysTemSpecialized implants and instruments for orthognathic surgery
The aim of surgical fracture treatment is to reconstruct thebony anatomy and restore its function. according to the ao, internal fixation is distinguished by anatomical reduction,stable fixation, preservation of blood supply, and early, active mobilization.1,2 Plate and screw osteosynthesis has been established and clinically recognized for some time.
Keeping the ao philosophy at its core, the matrix family is the new plating platform for internal fixation of the craniomaxillofacial skeleton–addressing neuro, craniofacial, mandibular, and orthognathic surgery. The matrix family is a simple, yet comprehensive, system that offers flexibility and ease of use.
Simplex all screws work with all plates within each matrix familyx one screwdriver for all screws within each matrix familyx Color‑coding by strength for easy identification
Effectivex low plate‑screw profile, where applicablex self‑retaining screws/bladesx rounded edges on plates
Efficientx standardized instrumentationx reduced inventory for hospitals, without
compromising clinical solutions
InTroduCTIon
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 3
matrixorThognaThIC Plating systemspecialized implants and instruments for orthognathic surgery
One screw diameter for all orthognathic indications
Reversible L-plates
Simple yet comprehensive system for orthognathic surgery
4 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
MatrixORTHOGNATHIC Screwsx one standard screw diameter – 1.85 mm screws (lefort I, bsso, genioplasty) – 2.1 mm screws serve as emergency screwsx screw designs include – self‑drilling (purple) – self‑tapping (blue) – emergency (pink)x screw lengths/thread pitch include – 4 mm–8 mm / 0.6 mm thread pitch – 10 mm–18 mm / 1.0 mm thread pitchx screw recess designed for – self‑retention on screwdriver blades – reduced screwdriver blade cam‑out – easy screw/blade re‑engagementx Titanium alloy (Ti‑6al‑7nb)
Notes: • A 1.55 mm diameter MatrixMIDFACE screw is
compatible with the MatrixORTHOGNATHIC Plating System.
• See page 14 for limitations regarding mandibular applications.
feaTures and benefITs
MatrixORTHOGNATHIC Plating Systemx matrixorThognaThIC is a simple yet comprehensive
system that offers precise implants and instruments for orthognathic surgery
x one standard screw diameter for all orthognathic indications in the midface and mandible
x reversible plates allow reduced inventory (where applicable)
x etched lines, in 1 mm increments, on implants provide a visual aid for plate bending (where applicable)
x Color‑coding by strength for easy identification
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 5
MatrixORTHOGNATHIC Plates
Maxillary Platesx l‑Plates – reversible design – etched lines, in 1 mm increments, to help determine
advancement – bar width increases as bar length increases – 0.5 mm thick plates (blue) – 0.7 mm thick plates (pink) – 0.8 mm thick plates (gold)x Pre‑bent maxillary plates with 2 mm to 10 mm
advancements are 0.8 mm thick (gold)x adaption plates in 0.5 mm (blue), 0.7 mm (pink),
and 0.8 mm (gold) thicknessesx I‑Plates in 0.5 mm (blue) and 0.7 mm (pink) thicknessx low profile x Commercially pure titanium
Note: The Maxillary Module will hold up to two thicknesses of L-plates. – 0.5 mm and 0.7 mm thicknesses – 0.5 mm and 0.8 mm thicknesses – 0.7 mm and 0.8 mm thicknesses
Sagittal Split Platesx adjustable slider plate – double‑strut design with a low profile – slider allows intraoperative correction of
occlusion during plate fixation – 0.7 mm thick (pink)x Curved and straight bsso plates – 6 mm to 12 mm bar lengths – etched lines, in 1 mm increments, to help determine
advancement – 1.0 mm thick (gold)x Commercially pure titanium
Genioplasty Platesx Pre‑bent chin plates with 4 mm to 10 mm advancementsx etched midline for easy centering x 0.7 mm thick (pink)x Commercially pure titanium
features and benefits
6 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
The color‑coding of implants in the matrixorThognaThIC Plating system helps to identify the level of strength. The color‑coding scale for plates and screws conforms to the matrix family strength color‑coding scheme.
MatrixORTHOGNATHIC Platesn blue = 0.5 mm thick plates n Pink = 0.7 mm thick plates n gold = 0.8 mm thick and greater plates
Note: The Maxillary Module will hold up to two thicknesses of L-plates. – 0.5 mm and 0.7 mm thicknesses – 0.5 mm and 0.8 mm thicknesses – 0.7 mm and 0.8 mm thicknesses
MatrixORTHOGNATHIC Screwsn blue = 1.85 mm diameter self‑tapping screws n Purple = 1.85 mm diameter self‑drilling screwsn Pink = 2.1 mm diameter self‑tapping emergency screws
also available: n silver = 1.55 mm diameter matrixmIdfaCe
self‑drilling screws n bronze = 1.55 mm diameter matrixmIdfaCe
self‑tapping screws
Note: A 1.55 mm diameter MatrixMIDFACE screw is compatible with the MatrixORTHOGNATHIC Plating System. See page 14 for limitations regarding mandibular applications.
maTrIxorThognaThIC PlaTe and sCrew Color‑CodIng
0.5 mm 0.7 mm 0.8 mm –1.0 mm
1.3 mm system/ 1.5 mm/2.0 mm system malleable
1.5 mm system/ 2.0 mm system
+2.0 mm system
MatrixORTHOGNATHIC 1.85 mm ScrewsScrew diameter Lengths Thread pitch Drill bit diameter
1.85 mm 4 mm–8 mm 0.6 mm 1.4 mm
1.85 mm 10 mm–18 mm 1.0 mm 1.4 mm
MatrixORTHOGNATHIC 2.1 mm Screws (emergency)Screw diameter Lengths Thread pitch
2.1 mm 4 mm–8 mm 0.6 mm
2.1 mm 10 mm–18 mm 1.0 mm
MatrixMIDFACE 1.55 mm ScrewsScrew diameter Lengths Thread pitch Drill bit diameter
1.55 mm 4 mm–8 mm 0.6 mm 1.1 mm
1.55 mm 10 mm–12 mm 0.6 mm 1.25 mm
Comparable to the orthognathic modular fixation system
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 7
ao PrInCIPles
In 1958, the ao formulated four basic principles, which havebecome the guidelines for internal fixation.1,2 They are:
Anatomic reductionfracture reduction and fixation to restore anatomical relationships. a comprehensive implant and instrument selection offers the ability to address most simple and complex fixation needs.
Stable fixationstability by rigid fixation (compression plating) or splintage,as the personality of the fracture and the injury requires.The matrixorThognaThIC Plate and screw system is optimized to achieve stable bone fixation.
Preservation of blood supplyPreservation of the blood supply to soft tissue and bone bycareful handling and gentle reduction techniques.
Early mobilizationearly and safe mobilization of the part and patient. ThematrixorThognaThIC system implants, combined with ao technique, provide stable fixation enough to allow a functional aftercare.
8 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
IndICaTIons
The DePuy Synthes Companies matrixorThognaThIC Plating system is intended for use in selective trauma of the midface and craniofacial skeleton, craniofacial surgery, reconstructive procedures, and selective orthognathic surgery of the maxilla, mandible, and chin in adolescents* (greater than 12 to 21 years of age) and adults.
specific Indications for use:x fractures of the midface and craniofacial skeletonx lefort I osteotomies, sagittal split osteotomies, and
genioplastiesx orthognathic surgery including reconstructive procedures
Warnings:• While the surgeon must make the final decision on
implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Implant removal should be followed by adequate postoperative management to avoid refracture.
• These devices can break during use (when subjected to excessive forces or outside the recommended surgical technique). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the patient, the broken part should be removed.
• Take care to remove all fragments that are not fixated during the surgery.
Precautions:• *Important considerations in achieving quality
outcomes for orthognatic surgery in growing patients include accurate diagnosis, proper treatment planning, and appropriate age sequencing of procedures.3
• Physicians should inform their patients about the implant’s load restrictions and develop a plan for postoperative behavior and increasing physical loads.
• Confirm that plate positioning, drill bit, and screw length allow for adequate clearance of the nerves,
tooth buds, and/or tooth roots, and the edge of the bone.• Confirm the quality of bone at the selected plate
position.• Predrilling is recommended in fractures with dense
bone.• Drill rate should never exceed 1800 RPM. Higher
rates can result in thermal necrosis of the bone, soft tissue burns, and an oversized hole to be drilled. The adverse effects of an oversized hole include reduced pullout force, increased ease of the screws stripping in bone, and/or suboptimal fixation.
• Always irrigate during drilling, ensure hole is drilled concentric to plate, and bone debris is removed.
• Avoid drilling over nerve or tooth roots.• Take care while drilling as to not damage, entrap, or
tear a patient’s soft tissue or damage critical structures. Be sure to keep drill clear of loose surgical materials.
• Handle devices with care and dispose worn bone- cutting instruments in a sharps container.
• Use the appropriate amount of screws to achieve stable fixation. Stable fixation requires a minimum of 2 screws per segment.
• Tighten screws in a controlled manner. Applying too much torque to the screws may cause screw/plate deformation, or bone stripping.
• Surgical implants must never be reused. An explanted metal implant must never be reimplanted. Even though the device appears undamaged, it may have small defects and internal stress patterns which could lead to breakage.
• After implant placement is complete, irrigate and apply suction for removal of debris potentially generated during implantation.
• Check instruments periodically for wear or damage. Replace worn or damaged instruments prior to use.
MR Information: The MatrixORTHOGNATHIC Plating System has not been evaluated for safety and compatibility in the MR environment. The MatrixORTHOGNATHIC Plating System has not been tested for heating or migration in the MR environment.
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 9
leforT I fIxaTIon
1Select plate design
Instrument
03.511.003 Plate holder for reversible matrix Plates
after the osteotomy has been performed and the new position of the maxilla has been established, select the plate shape, quantity, and thickness that best suits the bony anatomy, treatment objective, and quantity and quality of bone.
oblique l‑plates, 90° l‑plates, and I‑plates are recommended for both medial and lateral buttress fixation.
Pre‑bent maxillary plates are recommended for medial buttress fixation.
anatomic l‑plates are recommended for lateral buttress fixation.
2Select and form the bending template (optional)
Instruments
03.511.360 – bending Templates for matrix anatomic 03.511.362 l‑plates, 3x3 holes
03.511.363 – bending Templates for matrix oblique 03.511.365 l‑plates, 3x3 holes
03.511.366 – bending Templates for matrix 90° l‑Plates, 03.511.368 2x2 holes
select the appropriate shape and length of bending template according to the plate selection and form it to the bony anatomy.
Precaution: Bending templates should not be used as an implant or drill guide for surgical planning.
11 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
3Adapt plate to bone
Instruments
03.503.035 In‑plane Plate bender for midface Plates
03.503.038 Plate bender for midface Plates (2 required)
03.503.039 Plate Cutter for midface Plates
Cut and contour the plate according to the bending template and the bony anatomy using the Plate Cutters (03.503.039) and the Plate benders (03.503.038, 03.503.035) respectively. bend the plate between the holes as necessary. ensure the plate is passively adapted to the bone.
Notes: • Etched lines, in 1 mm increments, to facilitate
bending and placement. • Do not alter the bend in the pre-bent plates to
achieve more than a 1 mm adjustment in either direction.
Precaution: Damage to developing tooth roots may result in dento-oseous ankylosis and localized dentoalveolar growth impairment.4
Warnings: • Do not excessively bend or reverse bend the plates
as it may produce internal stresses which may become the focal point for eventual breakage of the implant.
• Ensure the plates are free from burrs/sharp edges after cutting.
lefort I fixation
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 11
4Fixate plate to bone
Insert proper length 1.85 mm matrix screws to fixate the plate to the underlying bone.
If pilot hole is desired, select the appropriate 1.4 mm diameter drill bit length to allow for the adequate clearance of nerves, tooth buds, and/or tooth roots.
engage the screw on the blade, align the blade over the cruciform recess, and slowly rotate it counterclockwise until the blade drops into the recess. firmly press the blade to fully seat it into the screw.
Confirm drill bit length matches screw length.
Note: Self-drilling and self-tapping screw are available.
lefort I fixation
12 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
sagITTal sPlIT fIxaTIon
1Select plate design
Instrument
03.511.003 Plate holder for reversible matrix Plates
after the sagittal split osteotomy, adjust the occlusion and the joint‑bearing segment, and stabilize by intermaxillary fixation.
select a plate shape that best suits the bony anatomy, treatment objective, and the quantity and quality of bone.
straight and curved sagittal split plates are available for monocortical screw placement.
The sagittal split Plate with adjustable slider is also available if intraoperative occlusal adjustments are necessary (see page 15 for technique).
Notes: • For bicortical screw placement, 1.85 mm diameter
Matrix screws are available in lengths up to 18 mm (position screws). Predrill using 1.4 mm diameter drill bit without stop.
• The 10 mm to 18 mm length screws have a larger head diameter for better visibility and force transmission.
2Select and form the bending template
Instruments
03.511.369 – bending Template for matrix Curved 03.511.372 sagittal split Plate
03.511.373 – bending Template for matrix straight 03.511.376 sagittal split Plate
select the appropriate shape and length of bending template according to the plate selection and form it to the bony anatomy.
Precaution: Bending templates should not be used as an implant or drill guide for surgical planning.
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 13
3Adapt plate to the bone
Instrument
03.503.038 Plate bender for midface Plates (2 required)
Contour the plate according to the bending template and make final adjustments to match the bony anatomy using the bending pliers (03.503.038). bend the plate between the holes as necessary. ensure the plate is passively adapted to the bone.
Note: Etched lines, in 1 mm increments, to facilitate bending and placement.
Precaution: Damage to developing tooth roots may result in dento-oseous ankylosis and localized dentoalveolar growth impairment.4
Warnings: • Do not excessively bend or reverse bend the plates,
which can produce internal stress which may become the focal point for eventual breakage of the implant.
• Ensure the plates are free from burrs/sharp edges after cutting.
sagittal split fixation
14 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
sagittal split fixation
1
4Fixate plate to the bone
select the appropriate 1.4 mm diameter drill bit length to allow for the adequate clearance of nerves, tooth buds, and/or tooth roots. Insert the appropriate length 1.85 mm matrix screws to fixate the plate to the underlying bone.
engage the screw on the blade, align the blade over the cruciform recess, and slowly rotate it counterclockwise until the blade drops into the recess. firmly press the blade to fully seat it into the screw.
Confirm drill bit length matches screw length.
Precaution: The 1.55 diameter MatrixMIDFACE Screw is not recommended for sagittal split fixation.
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 15
2Select and form the bending template (optional)
Instruments
03.511.377 – bending Template for sagittal split Plate, 03.511.378 with adjustable slider
select the appropriate length of bending template according to the plate selection and form it to the bony anatomy.
Precaution: Bending templates not to be used as an implant or drill guide for surgical planning.
sagITTal sPlIT PlaTe wITh adjusTable slIder (optional)
1Select plate design
Instrument
03.511.003 Plate holder for reversible matrix Plates
After the sagittal split osteotomy, adjust the occlusion and the joint-bearing segment, and stabilize by intermaxillary fixation.
select the appropriate sagittal split Plate with adjustable slider that best suits the bony anatomy, treatment objective, and the quantity and quality of bone.
16 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
3Adapt plate to the bone
Instrument
03.503.038 Plate bender for midface Plates (2 required)
Contour the plate according to the bending template and bony anatomy using the bending pliers (03.503.038). bend the plate between the holes as necessary. ensure the plate is passively adapted to the bone.
Notes: • Etched lines, in 1 mm increments, provide a visual
guide for bending.• Since the slider will not slide in the contoured
section, the plate should be contoured as far proximally as possible.
Precaution: Damage to developing tooth roots may result in dento-oseous ankylosis and localized dentoalveolar growth impairment.4
Warning: • Do not excessively bend or reverse bend the plates
as it may produce internal stresses which may become the focal point for eventual breakage of the implant.
sagittal split Plate with adjustable slider (optional)
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 17
4Primary plate fixation
select the appropriate 1.4 mm drill bit length to allow for the adequate clearance of nerves, tooth buds, and/or tooth roots.
fixate the sagittal split Plate with adjustable slider to the bone by drilling and inserting the proper length 1.85 mm matrix screws in the specified sequence as shown (1–3) (figure 1). screws should be placed monocortically.
engage the screw on the blade, align the blade over the cruciform recess, and slowly rotate it counterclockwise until the blade drops into the recess. firmly press the blade to fully seat it into the screw.
figure 1
sagittal split Plate with adjustable slider (optional)
23 1
18 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
5Operative correction of occlusion
release the intermaxillary fixation and inspect the occlusion.If the occlusion needs adjustment, loosen the screw (3) in the slider plate (figure 2).
The distal bone segment can now be shifted horizontally and vertically until the occlusion has been corrected.
retighten the screw (3) in the slider.
The process can be repeated if necessary.
Note: Ensure the desired condylar positioning has been achieved.
figure 2
3
sagittal split Plate with adjustable slider (optional)
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 19
6Final plate fixation
using the 1.4 mm diameter drill bit to drill, insert the remaining proper length 1.85 mm matrix screws in holes (4) and (5) (figure 3).
engage the screw on the blade, align the blade over the cruciform recess, and slowly rotate it counterclockwise until the blade drops into the recess. firmly press the blade to fully seat it into the screw.
remove the screw (3) and the slider plate component. ensure fixation of the mandible is adequate to withstand the sagittal forces.
Precautions:• The slider is strictly for intraoperative use only;
do not leave in-situ.• Previous changes in tempromandibular joint may
affect surgical outcome.
354
figure 3
sagittal split Plate with adjustable slider (optional)
21 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
2Adapt plate to bone
Instrument
03.503.038 Plate bender for midface Plates (2 required)
Contour the selected plate to the bone, using the plate benders. bend the plate between the holes as necessary. ensure the plate is passively adapted to the bone.
Notes: • Do not alter the bend in the pre-bent plates to
achieve more than a 1 mm adjustment in either direction.
• The etched centerline helps with plate alignment on the bone.
Precaution: Damage to developing tooth roots may result in dento-osseous ankylosis and localized dentoalveolar growth impairment.4
Warning: Do not excessively bend or reverse bend the plate, which can produce internal stresses which may become the focal point for eventual breakage of the implant.
genIoPlasTy fIxaTIon
1Select plate design
Instrument
03.511.003 Plate holder for reversible matrix Plates
after the osteotomy has been performed and the advance‑ment of the distal segment has been established, select the plate design that best suits the bony anatomy, treatment objective, and the quantity and quality of the bone.
The chin plates are available in 4 mm to 10 mm offsets.
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 21
3Fix plate to bone
use a 1.4 mm drill bit to drill, and insert the proper length 1.85 mm diameter matrix screws to fixate the plate to the bone.
engage the screw on the blade, align the blade over the cruciform recess, and slowly rotate it counterclockwise until the blade drops into the recess. firmly press the blade to fully seat it into the screw.
Note: Use at least two screws on each side of the osteotomy to achieve stable fixation.
genioplasty fixation
22 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
ImPlanTs
Titanium MatrixORTHOGNATHIC Screws
1.85 mm Self-tapping Screws (5/pkg.) length (mm)
04.511.204.05 4
04.511.205.05 5
04.511.206.05 6
04.511.208.05 8
04.511.210.05 10, coarse pitch
04.511.212.05 12, coarse pitch
04.511.214.05 14, coarse pitch
04.511.216.05 16, coarse pitch
04.511.218.05 18, coarse pitch
1.85 mm Self-drilling Screws (5/pkg.) length (mm)
04.511.224.05 4
04.511.225.05 5
04.511.226.05 6
04.511.228.05 8
2.1 mm Emergency Screws, self-tapping (5/pkg.) length (mm)
04.511.234.05 4
04.511.235.05 5
04.511.236.05 6
04.511.238.05 8
04.511.240.05 10, coarse pitch
04.511.242.05 12, coarse pitch
04.511.244.05 14, coarse pitch
04.511.246.05 16, coarse pitch
04.511.248.05 18, coarse pitch
note: screws are made of titanium alloy (Ti‑6al‑7nb).Plates are made of commercially pure titanium.
for single‑pack screws, change .05 to .01 at end of product number.
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 23
Titanium MatrixORTHOGNATHIC Plates
90° L-Plates, 2 x 2 holes, reversible Type bar length (mm) Thickness (mm)
04.511.301 short 2 0.5
04.511.302 medium 6 0.5
04.511.303 long 11 0.5
04.511.304 short 2 0.7
04.511.305 medium 6 0.7
04.511.306 long 11 0.7
04.511.307 short 2 0.8
04.511.308 medium 6 0.8
04.511.309 long 11 0.8
Oblique L-Plates, 3 x 3 holes, reversible Type bar length (mm) Thickness (mm)
04.511.321 short 4 0.5
04.511.322 medium 8 0.5
04.511.323 long 13 0.5
04.511.324 short 4 0.7
04.511.325 medium 8 0.7
04.511.326 long 13 0.7
04.511.327 short 4 0.8
04.511.328 medium 8 0.8
04.511.329 long 13 0.8
Oblique L-Plates, 3 x 4 holes, reversible Type bar length (mm) Thickness (mm)
04.511.331 short 4 0.5
04.511.332 medium 8 0.5
04.511.334 short 4 0.7
04.511.335 medium 8 0.7
Implants
24 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
Implants
Anatomic L-Plates, 3 x 3 holes, reversible Type bar length (mm) Thickness (mm)
04.511.341 short 4 0.5
04.511.342 medium 8 0.5
04.511.343 long 12 0.5
04.511.344 short 4 0.7
04.511.345 medium 8 0.7
04.511.346 long 12 0.7
04.511.347 short 4 0.8
04.511.348 medium 8 0.8
04.511.349 long 12 0.8
I-Plates, 4 holes Thickness (mm)
04.511.350 0.5
04.511.370 0.7
Pre-bent Maxillary Plates, 0.8 mm thick advancement (mm)
04.511.381 left 2
04.511.382 right 2
04.511.383 left 4
04.511.384 right 4
04.511.385 left 6
04.511.386 right 6
04.511.387 left 8
04.511.388 right 8
04.511.389 left 10
04.511.390 right 10
Adaption Plates, 20 holes Thickness (mm)
04.503.346 0.5 mm
04.503.376 0.7 mm
04.503.396 0.8 mm
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 25
Curved Sagittal Split Plates, 6 holes, 1.0 mm thick bar (mm)
04.511.401 6
04.511.402 8
04.511.403 10
04.511.404 12
Straight Sagittal Split Plates, 4 holes, 1.0 mm thick bar (mm)
04.511.421 6
04.511.422 8
04.511.423 10
04.511.424 12
Sagittal Split Plates with Adjustable Slider, 4 holes, 0.7 mm thick length (mm)
04.511.444 33
04.511.445 40
Chin Plates with Double Bend, 5 holes, 0.7 mm thick offset (mm)
04.511.461 4
04.511.462 6
04.511.463 8
04.511.464 10
Implants
26 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
seleCTed maTrIxorThognaThIC InsTrumenTs
03.503.034 mini Plate holder, long
03.503.035 In‑Plane Plate bender
03.503.038 Plate bender for midface Plates (2 required)
03.503.039 Plate Cutter for midface Plates
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 27
matrix 1.4 mm drill bits, j‑latch03.511.244 44.5 mm length, 4 mm stop03.511.246 44.5 mm length, 6 mm stop03.511.248 44.5 mm length, 8 mm stop03.511.252 44.5 mm length, 12 mm stop03.511.310 80 mm length 03.511.320 110 mm length 03.511.330 125 mm length
03.511.003 Plate holder for reversible matrix Plates
matrixmIdfaCe screwdriver blades, self‑retaining, hex coupling
03.503.201 52 mm03.503.202 76 mm03.503.203 96 mm
selected matrixorThognaThIC Instruments
28 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
selected matrixorThognaThIC Instruments
screwdriver handles, with hex coupling311.005 small311.006 medium311.007 large
311.023 ratcheting screwdriver handle
03.511.004 screwdriver handle with hex coupling, locking, medium
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 29
03.511.009 matrixorThognaThIC Trocar drill guide for 397.213
03.511.340 matrix 1.4 mm drill bit, j‑latch Calibrated for 03.511.009
TroCar sysTem
397.43 2.0 mm Cheek retractor ring
397.213 2.0 mm Cannula and obturator
397.211 universal Trocar handle
397.42 2.0 mm Cheek retractor blade
397.232 malleable C‑retractor
31 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
Maxillary Module Assembly 60.511.008 maxillary generic module (with lid) 60.511.009 maxillary module lid
60.511.006 screw, drill bit, blade Insert, with recessed holes
60.511.007* screw, drill bit, blade Insert, with no recessed holes
60.511.011 Pre‑bent Plate Insert
60.511.012 90° and oblique l‑Plate Insert
60.511.013 anatomic l and adaption Plate Insert
modules and aCCessorIes
* also available
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 31
modules and accessories
Mandible Module Assembly60.511.003 mandible generic module (with lid)60.511.004 mandible module lid
60.511.005 sagittal split Plate Insert
60.511.006 screw, drill bit, blade Insert, with recessed holes
60.511.007* screw, drill bit, blade Insert, with no recessed holes
60.511.010 Chin Plate Insert
Instrument Tray 60.511.014 Instrument Tray 60.511.015 Trocar Instrument Insert
* also available
32 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
Set01.503.514 matrixorThognaThIC Plating system set
Graphic Case and Modules60.511.001 graphic Case (with lid)60.511.002 graphic Case lid60.511.003 mandible generic module (with lid)60.511.004 mandible module lid60.511.005 sagittal split Plate Insert60.511.006 screw, drill bit, blade Insert with
recessed holes60.511.008 maxillary generic module (with lid)60.511.009 maxillary module lid60.511.010 Chin Plate Insert60.511.011 Pre‑bent Plate Insert60.511.012 90° and oblique l‑Plate Insert60.511.013 anatomic l and adaption Plate Insert60.611.014 Instrument Tray60.511.015 Trocar Instrument Insert
Label Sheets and Screw Length Markers label sheets60.511.016 for maxillary module60.511.017 for mandible module60.511.018 for Instrument Tray60.511.019 for screw length Color Chart60.511.020 for matrixmIdfaCe and
matrixorThognaThIC strength gradients
screw length markers, for self‑drilling screws (1/pkg.)
304.104w 4 mm304.105w 5 mm304.106w 6 mm304.108w 8 mm
screw length markers, for self‑tapping screws (10/pkg.)
304.104 4 mm 304.112 12 mm304.105 5 mm 304.114 14 mm304.106 6 mm 304.116 16 mm304.108 8 mm 304.118 18 mm304.110 10 mm
Also Available60.511.007 screw, drill bit, blade Insert, with
no recessed holes
maTrIxorThognaThIC PlaTIng sysTem
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 33
matrixorThognaThIC Plating system
Titanium MatrixORTHOGNATHIC Plates 90° l‑Plates, 2 x 2 holes, reversible04.511.301 short, 0.5 mm thick04.511.302 medium, 0.5 mm thick04.511.303 long, 0.5 mm thick04.511.304 short, 0.7 mm thick04.511.305 medium, 0.7 mm thick04.511.306 long, 0.7 mm thick04.511.307 short, 0.8 mm thick04.511.308 medium, 0.8 mm thick04.511.309 long, 0.8 mm thick
oblique l‑Plates, 3 x 3 holes, reversible04.511.321 short, 0.5 mm thick04.511.322 medium, 0.5 mm thick04.511.323 long, 0.5 mm thick04.511.324 short, 0.7 mm thick04.511.325 medium, 0.7 mm thick04.511.326 long, 0.7 mm thick04.511.327 short, 0.8 mm thick04.511.328 medium, 0.8 mm thick04.511.329 long, 0.8 mm thick
oblique l‑Plates, 3 x 4 holes, reversible04.511.331 short, 0.5 mm thick04.511.332 medium, 0.5 mm thick04.511.334 short, 0.7 mm thick04.511.335 medium, 0.7 mm thick
anatomic l‑Plates, 3 x 3 holes, reversible04.511.341 short, 0.5 mm thick04.511.342 medium, 0.5 mm thick04.511.343 long, 0.5 mm thick04.511.344 short, 0.7 mm thick04.511.345 medium, 0.7 mm thick04.511.346 long, 0.7 mm thick04.511.347 short, 0.8 mm thick04.511.348 medium, 0.8 mm thick04.511.349 long, 0.8 mm thick
I‑Plates, 4 holes04.511.350 0.5 mm thick04.511.370 0.7 mm thick
note: for single‑pack screws, change .05 to .01 at end of product number.
Titanium MatrixORTHOGNATHIC Screws 1.85 mm screws, self‑tapping (5/pkg.)04.511.204.05 4 mm04.511.205.05 5 mm04.511.206.05 6 mm04.511.208.05 8 mm04.511.210.05 10 mm, coarse pitch04.511.212.05 12 mm, coarse pitch04.511.214.05 14 mm, coarse pitch04.511.216.05 16 mm, coarse pitch04.511.218.05 18 mm, coarse pitch
1.85 mm screws, self‑drilling (5/pkg.)04.511.224.05 4 mm04.511.225.05 5 mm04.511.226.05 6 mm04.511.228.05 8 mm
2.1 mm screws, self‑tapping (5/pkg.)04.511.234.05 4 mm04.511.235.05 5 mm04.511.236.05 6 mm04.511.238.05 8 mm04.511.240.05 10 mm, coarse pitch04.511.242.05 12 mm, coarse pitch04.511.244.05 14 mm, coarse pitch04.511.246.05 16 mm, coarse pitch04.511.248.05 18 mm, coarse pitch
34 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
matrixorThognaThIC Plating system
Pre‑bent maxillary Plates, 0.8 mm thick04.511.381 2 mm advancement, left04.511.382 2 mm advancement, right04.511.383 4 mm advancement, left04.511.384 4 mm advancement, right04.511.385 6 mm advancement, left04.511.386 6 mm advancement, right04.511.387 8 mm advancement, left04.511.388 8 mm advancement, right04.511.389 10 mm advancement, left04.511.390 10 mm advancement, right
Curved sagittal split Plates, 6 holes, 1.0 mm thick
04.511.401 6 mm bar04.511.402 8 mm bar04.511.403 10 mm bar04.511.404 12 mm bar
straight sagittal split Plates, 4 holes, 1.0 mm thick
04.511.421 6 mm bar04.511.422 8 mm bar04.511.423 10 mm bar04.511.424 12 mm bar
sagittal split Plates with adjustable slider, 4 holes, 0.7 mm thick
04.511.444 33 mm04.511.445 40 mm
Chin Plates with double bend, 5 holes, 0.7 mm thick
04.511.461 4 mm offset04.511.462 6 mm offset04.511.463 8 mm offset04.511.464 10 mm offset
Titanium MatrixMIDFACE Plates adaption Plates, 20 holes04.503.346 0.5 mm thick04.503.376 0.7 mm thick04.503.396 0.8 mm thick
Instruments screwdriver handles with hex coupling311.005 small311.006 medium311.007 large311.023 ratcheting screwdriver handle,
hex coupling03.511.004 locking, medium
matrixmIdfaCe screwdriver blades, self‑retaining, hex coupling
03.503.201 52 mm03.503.202 76 mm03.503.203 96 mm
03.503.034 mini Plate holder, long03.511.003 Plate holder for reversible matrix Plates03.503.035 In‑Plane bender03.503.038 Plate bender (2 required)03.503.039 Plate Cutter347.98 Plate holding forceps
matrix 1.4 mm drill bits, stryker j‑latch03.511.244 44.5 mm, 4 mm stop03.511.246 44.5 mm, 6 mm stop03.511.248 44.5 mm, 8 mm stop03.511.252 44.5 mm, 12 mm stop03.511.310 80 mm length03.511.320 110 mm length03.511.330 125 mm length
Trocar system03.511.340 1.4 mm Calibrated drill bit, j‑latch 397.211 universal Trocar handle397.213 2.0 mm Cannula and obturator 03.511.009 matrixorThognaThIC Trocar drill guide 397.42 2.0 mm Cheek retractor blade397.43 2.0 mm Cheek retractor ring 397.232 malleable C‑retractor03.503.036 matrixmandIble depth gauge
MatrixORTHOGNATHIC Plating System Surgical Technique DePuy Synthes CMF 35
matrixorThognaThIC Plating system
Titanium MatrixMIDFACE Screws 1.55 mm Titanium MatrixMIDFACE
Screws, self-tapping (5/pkg.)04.503.204.05 4 mm 04.503.205.05 5 mm 04.503.206.05 6 mm 04.503.208.05 8 mm04.503.210.05 10 mm04.503.212.05 12 mm04.503.214.05 14 mm04.503.216.05 16 mm 04.503.218.05 18 mm
1.55 mm Titanium matrixmIdfaCe screws, self‑drilling (5/pkg.)
04.503.224.05 4 mm 04.503.225.05 5 mm 04.503.226.05 6 mm 04.503.228.05 8 mm
*bending templates cannot be used as drill guides.
Also Available matrix 1.4 mm drill bits03.511.342 universal Trocar drill bit, quick coupling,
Calibrated, (8 – 18 mm), 100 mm03.511.343 basic Trocar drill bit, j‑latch, calibrated,
125 mm
bending Templates, 0.5 mm thick*03.503.366 for adaption Plate, 20 holes03.511.360 for reversible anatomic l‑Plate, short03.511.361 for reversible anatomic l‑Plate, medium03.511.362 for reversible anatomic l‑Plate, long03.511.363 for reversible oblique l‑Plate, short03.511.364 for reversible oblique l‑Plate, medium03.511.365 for reversible oblique l‑Plate, long03.511.366 for reversible 90° l‑Plate, short03.511.367 for reversible 90° l‑Plate, medium03.511.368 for reversible 90° l‑Plate, long03.511.369 for Curved sagittal split Plate, 6 mm bar03.511.370 for Curved sagittal split Plate, 8 mm bar03.511.371 for Curved sagittal split Plate, 10 mm bar03.511.372 for Curved sagittal split Plate, 12 mm bar03.511.373 for straight sagittal split Plate, 6 mm bar03.511.374 for straight sagittal split Plate, 8 mm bar03.511.375 for straight sagittal split Plate, 10 mm bar03.511.376 for straight sagittal split Plate, 12 mm bar03.511.377 for sagittal split Plate with slider, 33 mm03.511.378 for sagittal split Plate with slider, 40 mm
1.5 mm drill bits, stryker j‑latch317.64 44.5 mm length, 4 mm stop317.66 44.5 mm length, 6 mm stop317.68 44.5 mm length, 8 mm stop317.72 44.5 mm length, 12 mm stop317.435 85 mm length, 60 mm stop317.835 110 mm length
matrix 1.4 mm drill bits for 90° screwdriver03.505.141 13 mm length, 6 mm stop03.505.144 15 mm length, 8 mm stop03.505.147 19 mm length, 12 mm stop03.505.165 21 mm length, 14 mm stop03.505.166 23 mm length, 16 mm stop03.505.167 25 mm length, 18 mm stop
68.505.060 mini module for matrixorThognaThIC, for 90° screwdriver
36 DePuy Synthes CMF MatrixORTHOGNATHIC Plating System Surgical Technique
referenCes
1. müller, me, m. allgöwer, r. schneider, h. willenegger. Manual of Internal Fixation, 3rd edition. berlin: springer‑Verlag. 1991.
2. rüedi, TP, re. buckley, Cg. moren. AO Principles of Fracture Management. 2nd expanded ed. 2002. stuttgart, new york: Thieme.
3. schendel sa, wolford lm, epker bn. surgical advancement of the mandible in growing children: Treatment results in twelve patients. J Oral Surg. 1976;45.
4. wolford lm, Karras sC, mehra P. Considerations for orthognathic surgery during growth, part 2: maxillary deformities. Am J Orthod Dentofacial Orthop. 2001;119:102‑105.
Manufactured by (United States):Synthes USA Products, LLC1302 wrights lane eastwest Chester, Pa 19380 Telephone: (610) 719‑5000 To order: (800) 523‑0322 fax: (610) 251‑9056
www.depuysynthes.com
© dePuy synthes Cmf, a division of doI 2015. all rights reserved. dsus/Cmf/1114/0249 12/14 dV
Some devices listed in this technique guide may not have been licensed in accordance with Canadian law and may not be for sale in Canada. wPlease contact your Sales Consultant for items approved for sale in Canada.
Limited Warranty and Disclaimer: DePuy Synthes CMF products are sold with a limited warranty to the original purchaser against defects in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed.
WARNING: In the USA, this product has labeling limitations. See package insert for complete information.
Rx Only
not all products are currently available in all markets.
Legal Manufacturer (Canada):Synthes (Canada) Ltd. 2566 meadowpine boulevard mississauga, ontario l5n 6P9 Telephone: (905) 567‑0440 To order: (800) 668‑1119 fax: (905) 567‑3185