Treatment of massive obesity by prolonged jaw immobilization for edentulous patients

Twenty massively obese patients who were edentulous in one or both jaws were treated by prolonged jaw immobilization. Dentures were secured under general anaesthesia to the edentulous jaws by various direct wiring methods and the jaws immobilized by interdental wires, where teeth were present, and intermaxillary wires. The wired-in dentures were generally well tolerated with minimal mucosal reaction but with a high incidence of infection around the attachment wires. Patients edentulous in one jaw alone, (11 maxilla, two mandible), managed well and 11 achieved a satisfactory weight loss. The seven patients edentulous in both jaws had considerable difficulty with pain and infection, three having the fixation appliances removed in the immediate post-operative period and only one achieved a satisfactory weight loss. Thus prolonged jaw immobilization is an effective means of treating massively obese patients if they are edentulous in one jaw alone but less so if they are completely edentulous.