Main Article Content
Palatal vault fracture, anterior alveolar plating, palatal vault plating, maxillary buttress stabilization
Background: Various approaches for managing sagittal maxillary fractures have been documented, each with its own set of pros and cons. In this report, we share our own experiences and outcomes concerning the utilization of reverse pre-activated maxillary expanders, while also assessing their effectiveness. This study aimed to facilitate effective management, the patients were split into three consecutive groups on the basis of their specific fracture type and presentation.
Methods: This study comprised of 120 patients who were diagnosed with sagittal maxillary fractures. These fractures were further categorized into six distinct subgroups based on the location and severity.
Results: Sagittal maxillary fractures exhibited a higher prevalence among young men. Notably, Le Fort i and ii fractures were observed recurringly either as isolated injuries or in combination with other fracture types. Sagittal and parasagittal fractures represented bulk prevalence in fracture subtypes. The study included the management of 32 patients in group A, 40 patients in group B, and 48 patients in group C. The most common complications encountered were malocclusion (4 cases), plate extrusion (4 cases), and oroantral fistula (4 cases).
Conclusion: The diagnosis of a sagittal maxillary fracture involves clinical and radiological examinations. “Palatal fractures” of type ii and iii displaced necessitate palatal vault plating. The placement of one plate in the post 1/2 of the middle 1/3 of the palate provides adequate stability to the palatal vault.
2. Killey HC, Banks P. Killey's fractures of the middle third of the facial skeleton. (No Title). 1981.
3. Ma D, Guo X, Yao H, Chen J. Transpalatal screw traction: a simple technique for the management of sagittal fractures of the maxilla and palate. International Journal of Oral and Maxillofacial Surgery. 2014 Dec 1;43(12):1465-7.
4. Carlton DM, WH W. Fabrication of a head frame for the treatment of facial fractures.
5. Antoniades K, Dimitriou C, Triaridis C, Karabouta I, Layaridis N, Karakasis D. Sagittal fracture of the maxilla. Journal of Cranio-Maxillofacial Surgery. 1990 Aug 1;18(6):260-2.
6. Morgan BD, Madan DK, Bergerot JP. Fractures of the middle third of the face—a review of 300 cases. British Journal of Plastic Surgery. 1972 Jan 1;25:147-51.
7. Chen CH, Wang TY, Tsay PK, Lai JB, Chen CT, Liao HT, Lin CH, Chen YR. A 162-case review of palatal fracture: management strategy from a 10-year experience. Plastic and reconstructive surgery. 2008 Jun 1;121(6):2065-73.
8. Hendrickson M, Clark N, Manson PN, Yaremchuk M, Robertson B, Slezak S, Crawley W, Vander Kolk C. Palatal fractures: classification, patterns, and treatment with rigid internal fixation. Plastic and reconstructive surgery. 1998 Feb 1;101(2):319-32.
9. Killey HC, Banks P. Killey's fractures of the middle third of the facial skeleton. (No Title). 1981.
10. Park S, Ock JJ. A new classification of palatal fracture and an algorithm to establish a treatment plan. Plastic and reconstructive surgery. 2001 Jun 1;107(7):1669-76.
11. Melsen B. A histological study of the influence of sutural morphology and skeletal maturation on rapid palatal expansion in children. Transactions. European Orthodontic Society. 1972 Jan 1:499-507.
12. Kahnberg KE, Göthberg KA. Le Fort fractures.(I) A study of frequency, etiology and treatment. International journal of oral and maxillofacial surgery. 1987 Apr 1;16(2):154-9.
13. Hoppe IC, Halsey JN, Ciminello FS, Lee ES, Granick MS. A single-center review of palatal fractures: etiology, patterns, concomitant injuries, and management. Eplasty. 2017;17.