Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 8 2 2021 10 02 84 90 Mehrnoush Momeni Roochi Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Narges Hajiani Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sayna Nezaminia Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2021 05 11 2021 06 07 A therapeutic challenge to maxillofacial surgeons is management of panfacial fractures, especially when treating multiple comminuted bone fractures. One of the most important goals in these fractures is achieve and stablish a correct occlusal relationship of the mandibular-maxillary unit in parallel with the proper positioning of the jaws with the skull base and other facial units. Also, it is important to prevent long-term sequelae such as facial asymmetry, enophthalmos, and malocclusion that could be caused by inadequate correction. To achieve all these goals some usual guides of management are proposed as follow: “Bottom to up”, “Top to down”, “outside to inside,” or “inside to outside”. We present 3 cases of Panfacial fracture and the proposed methods were based on different sequences of management with introducing “reference point” as the most intact area to determine the management concept & “confirming point” as the areas that should be reduced and fixed completely. These points act as an orientation aid during surgery and aid to successfully restore the entire face contour and maxillomandibular occlusion and also to improves surgical procedure. Keywords: Panfacial fracture; Internal fixation; Open reduction; Reference point; Confirming point. https://jcr.tums.ac.ir/index.php/jcr/article/view/372 https://jcr.tums.ac.ir/index.php/jcr/article/download/372/327