A Novel Adjuvant to Treat Palatal Fractures

Abstract

Palatal fractures are relatively rare but generally occur along with maxillary fractures. The average incidence of palatal fractures combined with maxillary fractures ranges from 8% to 20%, although a much higher ncidence has recently been reported (46.4%). Traditionally, anatomic reduction of palatal fractures is considered difficult. Although various techniques prevail, ranging from invasive open reduction and internal fixation (ORIF), Kirschner wire fixation, to oninvasive techniques such as stabilization of the axillary arch using an arch bar, transpalatal wiring, intraosseous wiring, acrylic splints, and intermolar wiring, all have inherent difficulties and drawbacks. ORIF requires a wide mucoperiosteal flap elevation, which is not so easy in the palate because of the tightly adherent mucoperiosteum, which might damage the soft tissue, partly jeopardizing the blood supply. It could also result in exposure of hardware and delayed nasal bleeding. Moreover, there is an inherent risk of occlusal disruption when not accompanied by maxillomandibular fixation. Therefore, seeking an alternative for timeconsuming ORIF associated with many intricacies seems to be judicious. Intraosseous and transpalatal wiring techniques carry similar disadvantages at varying degrees. Techniques using the arch bar and splint aim at stabilization of the maxilla but unfortunately play only a passive role in bringing the fractured components together and are ineffective in minimizing the gap