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4Fixation

Fixation

Splint application

In some cases, the surgeon may consider taking dental impressions, making dental models, and from these models making a palatal splint. Such a splint will support soft-tissue healing in the palate. The palatal splint is then wired to the dentition also possibly using arch bars. Depending on the stability of the palatal unit, as well as other complicating issues regarding other midface fractures and postoperative airway, the surgeon may choose to leave the patient in postoperative MMF.

In cases where there has been splaying of the palate, cuts are made in the maxillary portion of the dental model, along the line of the palatal fracture, with repositioning of the maxillary model to determine the premorbid contour of the maxillary arch. This is accomplished using the mandibular impression. Once the maxillary model has been adjusted to its premorbid shape, the palatal splint is made with the use of this maxillary model.