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Closed treatment of complex palatoalveolar injuries preserves the blood supply of the comminuted segments.

Perform reduction by applying pressure laterally on the two maxillary halves to reduce the splayed fracture. This maneuver needs to be performed while the palatal splint is in place, as the splint offers the best guide as to whether an adequate reduction has been achieved. It may be necessary to continue this pressure while applying the arch bars. There may be an advantage of applying wires from the splint to the arch bar. It may be necessary in some cases to wire the splint to the teeth, and the arch bars to the teeth independently.

Depending on the degree of dentoalveolar trauma one may not be able to use a palatal splint.

Note: The focus has to be on to reestablishing occlusion and the transverse bony dimension.