Skip to main content

Advertisement

Log in

Management of Maxillary Sagittal Fracture by using Pre-activated Rapid Maxillary Expansion (RME)

  • Original Article
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Introduction

Different techniques of the management of sagittal maxillary fractures have been described with different advantages and disadvantages. We herein present our experience and results of managing these cases by reversing pre-activated maxillary expanders and evaluation of its efficacy.

Patient and Methods

A prospective study was conducted from April 2016 to February 2020 including all the patients managed for sagittal palatal fractures using the modified technique. The patients were evaluated for healing, occlusion and complications.

Results

A total of five patients with sagittal palatal fracture were managed. The mean Glasgow Coma (GCS) score and injury severity score (ISS) of patients were 11.6 ± 2.4 and 15.2 ± 4.3, respectively. Both had a significant strong negative correlation with a correlation coefficient of − 0.889 (p = 0.44). The median duration for initiating the treatment for facial fractures was 2 days (range 2–12 days). All patients achieved satisfactory outcomes and tolerated this technique well. No obvious complications were found.

Conclusion

This method could produce enough transversal force to reduce fractured fragments and then serve as an external fixator to maintain stability for bony healing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Manson PN, Glassman D, Vanderkolk C et al (1990) Rigid stabilization of sagittal fractures of the maxilla and palate. Plast Reconstr Surg 85:711–717. https://doi.org/10.1097/00006534-199005000-00010

    Article  CAS  PubMed  Google Scholar 

  2. Ma D, Guo X, Yao H, Chen J (2014) Transpalatal screw traction: A simple technique for the management of sagittal fractures of the maxilla and palate. Int J Oral Maxillofac Surg 43:1465–1467. https://doi.org/10.1016/j.ijom.2014.07.019

    Article  CAS  PubMed  Google Scholar 

  3. S. P, J.J. O, (2001) A new classification of palatal fracture and an algorithm to establish a treatment plan. Plast Reconstr Surg 107:1669–1676

    Article  Google Scholar 

  4. Kumaravelu C, Thirukonda GJ, Kannabiran P (2011) A novel adjuvant to treat palatal fractures. J Oral Maxillofac Surg. https://doi.org/10.1016/j.joms.2010.12.053

    Article  PubMed  Google Scholar 

  5. Hendrickson M, Clark N, Manson PN et al (1998) Palatal fractures: Classification, patterns, and treatment with rigid internal fixation. Plast Reconstr Surg 101:319–332. https://doi.org/10.1097/00006534-199802000-00009

    Article  CAS  PubMed  Google Scholar 

  6. Rai A (2017) 3 Dimensional plate in management of sagittal palatal fracture: a novel technique. J Maxillofac Oral Surg 16:497–499. https://doi.org/10.1007/s12663-016-0931-5

    Article  PubMed  Google Scholar 

  7. Moss WJ, Kedarisetty S, Jafari A et al (2016) A review of hard palate fracture repair techniques. J Oral Maxillofac Surg 74:328–336

    Article  Google Scholar 

  8. Chen CH, Wang TY, Tsay PK et al (2008) A 162-case review of palatal fracture: Management strategy from a 10-year experience. Plast Reconstr Surg 121:2065–2073. https://doi.org/10.1097/PRS.0b013e3181706edc

    Article  CAS  PubMed  Google Scholar 

  9. Zimring JF, Isaacson RJ (1965) Forces produced by rapid maxillary expansion. 3. Forces present during retention. Angle Orthod 35(3):178–186. Doi: https://doi.org/10.1043/0003-3219(1965)035<0178:FPBRME>2.0.CO;2

  10. Cienfuegos R, Sierra E, Ortiz B, Fernández G (2010) Treatment of palatal fractures by osteosynthesis with 2.0-mm Locking plates as external fixator. Craniomaxillofac Trauma Reconstr 3:223–230. https://doi.org/10.1055/s-0030-1268519

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kapse S, Surana S, Shastri AK (2017) Transpalatal wiring for the management of sagittal fracture of the maxilla/palate. Int J Oral Maxillofac Surg 46:1059–1060

    Article  Google Scholar 

  12. Meslemani D, Kellman RM (2012) Zygomaticomaxillary complex fractures. Arch Facial Plast Surg 14:62–66

    Article  Google Scholar 

  13. Hino CT, Pereira MD, Sobral CS et al (2008) Transverse effects of surgically assisted rapid maxillary expansion: a comparative study using Haas and Hyrax. J Craniofac Surg 19:718–725. https://doi.org/10.1097/SCS.0b013e31816aaa91

    Article  PubMed  Google Scholar 

  14. Koudstaal MJ, Poort LJ, van der Wal KGH et al (2005) Surgically assisted rapid maxillary expansion (SARME): a review of the literature. Int J Oral Maxillofac Surg 34:709–714

    Article  CAS  Google Scholar 

  15. Mommaerts MY (1999) Transpalatal distraction as a method of maxillary expansion. Br J Oral Maxillofac Surg 37:268–272. https://doi.org/10.1054/bjom.1999.0127

    Article  CAS  PubMed  Google Scholar 

  16. Batra J, Attresh G, Garg B (2015) Response to ‘Transpalatal screw traction: A simple technique for the management of sagittal fractures of the maxilla and palate.’ Int J Oral Maxillofac Surg 44:670–671

    Article  CAS  Google Scholar 

Download references

Acknowledgements

None.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohammed Rashid.

Ethics declarations

Conflict of interest

Authors would like to declare there is no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tiwari, P., Mishra, N., Rashid, M. et al. Management of Maxillary Sagittal Fracture by using Pre-activated Rapid Maxillary Expansion (RME). J. Maxillofac. Oral Surg. 21, 759–764 (2022). https://doi.org/10.1007/s12663-021-01516-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-021-01516-1

Keywords

Navigation