The Treatment of Maxillary Fracture with Malocclusion

ABSTRACT

Twenty-five Le Fort fractures accompanying palatal fracture or malocculsion had been studied from October 1990 to May 1997. The patients were analyzed on the basis of classification causes, operative procedure treatment of fracture, status of malocclusion and complication. The most common cause of fracture was a traffic accident and diagnosis was performed by history, physical examination, reontgenogram, and computed tomography. The follow-up period ranged from 5 months to 5 years, averaging 17 months. Internal fixations with plates and screws were performed in 22 cases and external fixations with halo apparatus were used in 3 cases. Intermaxillary fixations with arch bar were applied during the preoperative and postoperative period in all cases. In 6 cases of Le Fort fractures, acylic splints were applied. In 3 cases of palatal fractures, transverse wiring of the palatal arch were also used. Overall 19 of 25 patients were satisfied with the results. Six patients complained about depression of the midface because of undercorrection 4 patients had persisting hypoesthesia of the infraorbital nerve for more than 6 months postoperative. In summary, the dental plast and acrylic splint are very helpful in correcting malocclusion in severe maxillary fractures. Also, in cases of palatal fracture, it is important to minimize maloccusion by rigid fixation or transverse wiring of the palatal arch.