<![CDATA[Background: Open comminuted mandibular parasymphyseal fractures present significant challenges due to fragment instability, disrupted occlusion, and increased risk of complications, particularly in cases with dental malalignment where conventional stabilization methods are limited. Objective: To report the application of interdental tension band wiring as a pre-ORIF reduction adjunct in an open comminuted mandibular parasymphyseal fracture.Case: A 41-year-old male presented with anterior open bite and intraoral bleeding following a motor vehicle accident. Clinical and radiographic findings confirmed an open OCSS CMF Type II left mandibular parasymphyseal fracture with dental malalignment. Conventional adjuncts such as arch bars were considered suboptimal due to the risk of further displacement and periodontal injury. Case Management: Interdental tension band wiring using a 0.4-mm multiple loop configuration was applied as a pre-ORIF reduction aid, followed by definitive fixation with a 2.4-mm reconstruction plate. The technique enabled controlled fragment approximation through dental–periodontal anchorage. At one-month follow-up, satisfactory wound healing, stable occlusion, and normal mandibular function were achieved without complications. Conclusion: Interdental tension band wiring may serve as a practical and cost-effective reduction adjunct in selected cases of open comminuted mandibular parasymphyseal fracture with dental malalignment, offering a clinically adaptable approach when conventional techniques are limited. Keywords: Bone plates, fracture fixation, malocclusion, mandibular fractures]]>
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