Evaluating the Effectiveness of Overmucosal Plating in Management of Maxillary Palatal Fracture

Palatal fractures are frequently associated with maxillary fractures in midfacial trauma. These fractures may cause diagnostic and therapeutic challenges. If treated improperly, results would be malunion, malocclusion, and oronasal fistula formation. Herein, we aimed to evaluate the effectiveness of the conventional miniplates used overmucosaly in the management of maxillary palatal fracture.
Under general anesthesia, arch bar was fixed to the existing teeth. After fixation of palatal fractures, appropriate occlusion was obtained by transpalatal wiring. Fixation of palatal fractures was performed with a conventional four-hole, straight-bar miniplate with 2 mm thickness and four 8-mm-long screws on both fracture sides. The patients remained with intermaxillary fixation for seven days and elastic therapy for two weeks. Miniplate and screws were removed about 8-12 weeks after their application. Follow-up was performed every three months for one year.
This technique was applied for 10 trauma patients with maxillary palatal fracture. Palatal overmucosal plate and screws remained rigid in their position until their removal. None of the patients suffered from oronasal fistula, bone exposure, or mucosal necrosis. Interference with speech and swallowing, as well as tongue irritation and difficulty in oral hygiene maintenance were not reported by any of the patients. Palatoalveolar segments remained in proper position, and pretraumatic occlusal patterns and facial width were restored except in one case.
Fixation of the palatal fractures with the conventional miniplates without elevation of mucoperiosteal flap helps with stability and preventing palatal width problems. In so doing, complications including fistula formation and interference with oral cavity functions are avoided.