Splint-assisted reduction of comminuted or complex maxillofacial fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Trauma Surgery

Background:

• Complex and comminuted facial fractures, especially those involving the mandible and condyle, often lead to occlusal disharmony and aesthetic impairments.
• Restoring premorbid occlusion and achieving anatomic bone healing are critical goals in managing these severe injuries.

Purpose of the Study:

• To evaluate the efficacy of splint-assisted reduction and internal fixation using premorbid occlusal splints and direct bonded orthodontic brackets.
• To achieve anatomic bone healing and restore premorbid occlusion in patients with complex or comminuted facial fractures.

Main Methods:

• Ten patients with complex/comminuted facial and mandibular fractures underwent treatment with premorbid occlusal splints and direct bonded orthodontic brackets.
• Splint-assisted reduction and internal fixation were performed, followed by 4-6 weeks of intermaxillary fixation over the splint.

Main Results:

• Complete bone healing was observed in all fracture lines without major complications requiring further intervention.
• Minor malocclusion occurred in one patient with panfacial fractures; slight avascular condylar resorption was noted in one patient with an open comminuted mandibular fracture.

Conclusions:

• The use of orthodontic splints and direct bonded brackets is an effective method for achieving and maintaining precise reduction.
• This technique successfully prevents occlusal disharmony and aesthetic deficits in patients with comminuted lower facial unit and complex facial fractures.