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Novel Custom Maxillary Disimpaction Splint.

Lisa Jolly1, Jack D Sudduth1, Jessica L Marquez1

  • 1From the University of Utah Hospital, Department of Surgery, Division of Plastic Surgery, Salt Lake City, Utah.

Plastic and Reconstructive Surgery. Global Open
|May 14, 2023
PubMed
Summary
This summary is machine-generated.

A custom disimpaction splint improves LeFort osteotomy outcomes for patients with cleft or traumatized palates. This device minimizes complications during maxillary downfracture, enhancing surgical safety and patient recovery.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Craniofacial Reconstruction
  • Biomaterials Engineering

Background:

  • LeFort I, II, and III osteotomies are crucial for craniofacial reconstruction in patients with clefts, congenital deformities, or trauma.
  • Compromised palatal bone support in these patients increases risks during maxillary downfracture, including mucosal trauma, fistula formation, and bone fractures.
  • Existing methods lack adequate protection for the palate and alveolar bone during disimpaction.

Purpose of the Study:

  • To introduce and evaluate a custom maxillary disimpaction splint designed to mitigate complications during LeFort osteotomies.
  • To enhance surgical stability and protect vulnerable oral and nasal structures during the downfracture procedure.
  • To improve patient outcomes in complex craniofacial reconstructions involving palatal defects.

Main Methods:

  • Development of a custom disimpaction splint with a two-layered biocryl base and soft-cushion rebase material.
  • The splint is designed to cover palatal and occlusal surfaces for secure grip and minimal movement.
  • Routine clinical application of the splint in LeFort osteotomies for patients with compromised palates since September 2019.

Main Results:

  • The custom splint provided a stable grip for disimpaction forceps, minimizing intraoperative movement.
  • No surgical complications related to the maxillary downfracture were reported during the study period.
  • The splint effectively protected the cleft, traumatized palate, and alveolar bone graft sites.

Conclusions:

  • Routine use of the custom maxillary disimpaction splint significantly reduces complications associated with LeFort osteotomies.
  • The splint enhances surgical safety and efficacy in patients with cleft and traumatized palates.
  • This innovative device represents a valuable advancement in craniofacial reconstructive surgery.