Closed treatment may be considered in a patient where on CT a fracture line with no splaying is visible, but there is possible instability of the fracture. In some cases, the surgeon may want to consider taking dental impressions, making dental models, and from these models making a palatal splint. The palatal splint is then wired to the dentition possibly also using arch bars. The patient is commonly left in MMF until adequate healing of the palatal fracture has occurred.
In the photographs, dental impressions have been taken, models have been made, …
… and a clear plastic palatal splint has been made.
In this photograph, the palatal splint has been inserted. Holes have been drilled through the palatal splint. These holes have been used to fix the wires to the arch bar.
Note: The focus has to be on reestablishing occlusion and the transverse bony dimension.
If there are dental models from previous treatments available, this may be helpful.