Comparison of short-term effects of presurgical nasoalveolar molding and Hotz’s plate on maxillary arch form in unilateral cleft lip and palate

2019 ◽  
Vol 31 (1) ◽  
pp. 25-30
Author(s):  
Takao Fuchigami ◽  
Namiko Kimura ◽  
Masahiro Tezuka ◽  
Toshiro Kibe ◽  
Muhammad Subhan Amir ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Short Term ◽  
Arch Form ◽  
Nasoalveolar Molding ◽  
Maxillary Arch ◽  
Short Term Effects

Short-Term Efficacy of Presurgical Vacuum Formed Nasoalveolar Molding Aligners on Nose, Lip, and Maxillary Arch Morphology in Infants With Unilateral Cleft Lip and Palate: A Prospective Clinical Trial

2020 ◽  
pp. 105566562096618
Author(s):  
Khadega Ali Al Khateeb ◽  
Mai Aboul Fotouh ◽  
Fatma Abdelsayed ◽  
Fady Fahim
Keyword(s):  
Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Prospective Clinical Trial ◽  
Posterior Arch ◽  
Digital Models ◽  
Short Term ◽  
Arch Width ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objectives: The purpose of this study was to evaluate the short-term effect of series of preadjusted vacuum formed nasoalveolar molding VF NAM aligners on the morphology of nose, lip, and maxillary arch in infants with unilateral cleft lip and palate (UCLP). Design: Prospective clinical trial. Setting: Unilateral cleft lip and palate patients referred to outpatients’ clinic. Patients: Sixteen nonsyndromic infants with UCLP, less than 2 months of age were included from April 2017 to April 2018. Interventions: All infants received VF NAM therapy. Standardized digital frontal and basilar photographs and 3D digital models were taken before initiation of VF NAM therapy (T1) and after completion of VF NAM therapy (T2). Main Outcome Measure(s): Changes in morphology of the nose, lip, and maxillary arch. Results: Statistical analysis comparing T1 and T2 measurements was performed. Frontal and basilar photographic analysis showed a statistically significant reduction of columella displacement, interlabial gap distance, and nostril width at cleft side (CS), while the nasal height, nostril height at CS, nostril width at noncleft side (NCS), columella deviation angle, nasal tip protrusion, and nostril area at both CS and NCS increased significantly with VF NAM therapy. The nasal width, nostril height at NCS showed no significant change after presurgical VF NAM aligners therapy. The analysis of digital models demonstrated a statistically significant reduction of alveolar cleft width, anterior arch width, arch length, midline deviation, and palatal cleft width, while the posterior arch width and arch perimeter increased significantly with VF NAM therapy. Conclusion: Vacuum formed NAM therapy was effective in reducing the nasoalveolar deformities associated with infants with UCLP and improved the alveolar morphology and nasal symmetry.

Relapse Tendency in Maxillary Arch Width in Unilateral Cleft Lip and Palate Patients with Different Maxillary Arch Forms

2008 ◽  
Vol 45 (3) ◽  
pp. 278-283 ◽  
Author(s):  
Talat Al-Gunaid ◽  
Toshikazu Asahito ◽  
Masaki Yamaki ◽  
Kooji Hanada ◽  
Ritsuo Takagi ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Arch Form ◽  
Group A ◽  
The Stability ◽  
Arch Forms ◽  
Group B ◽  
Severe Degree ◽  
Maxillary Arch

Objective: The aim of this study was to investigate the relapse tendency in the maxillary dental arch widths in unilateral cleft lip and palate patients with different types of maxillary arch form. Subjects: Thirty-two unilateral cleft lip and palate patients treated by one-stage surgical palatal closure were included. The subjects were divided into three groups according to the types of the maxillary arch forms: group A, symmetrical arch form; group B, collapse of minor segment; group C, collapse of both segments. Methods: Using dental casts obtained at three different times, relapse in the intercanine, interpremolar, and intermolar widths in each group was assessed and differences between groups were investigated. Results: Patients in group A showed stable results in all measurements. Patients in group B showed posttreatment relapse in the intercanine width only, whereas patients in group C demonstrated significant posttreatment relapses in the interpremolar and intermolar widths. Comparison between groups showed more significant relapse in the interpremolar and intermolar widths of group C than in those of group B. Conclusion: The types of the maxillary arch forms in unilateral cleft lip and palate patients might play a stronger role in the stability of the maxillary dental arch widths after orthodontic treatment in patients with collapse of both segments and a severe degree of maxillary narrowness.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate: A Preliminary Study

2007 ◽  
Vol 44 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Christopher F. Ezzat ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jung-Wei Chen ◽  
Robin G. Stratmann ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Significant Positive Correlation ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
Alveolar Cleft ◽  
Arch Width ◽  
Preliminary Study ◽  
A Prospective Study ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP). Design: A prospective study with blinded measurements. Patients: Twelve patients with UCLP treated from 1997 to 2003. Interventions: The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days. Main Outcome Measures: Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements. Results: After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05). Conclusions: PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

Function of Nasoalveolar Molding Devices in Bilateral Complete Cleft Lip and Palate: A 3-Dimensional Maxillary Arch Analysis

2021 ◽  
pp. 105566562199018
Author(s):  
Pawinee Tankittiwat ◽  
Araya Pisek ◽  
Montien Manosudprasit ◽  
Pattama Punyavong ◽  
Amornrut Manosudprasit ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Case Series ◽  
Posterior Arch ◽  
3 Dimensional ◽  
Time Points ◽  
Arch Width ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: This study aimed to observe and analyze the effects of nasoalveolar molding (NAM) on maxillary arch dimensions in patients with bilateral complete cleft lip and palate (BCLP) using 3-dimensional analyses. Design: Retrospective case series. Materials and Methods: Seventeen infants were treated using modified Khon Kaen University presurgical nasoalveolar molding devices (KKU-NAM). Dental casts were evaluated 3 dimensionally at 3 time points: pretreatment (T1), after using modified KKU-NAM for 2 weeks (T2), and before cheiloplasty (T3). Repeated-measures analysis of variance and Friedman test were used to compare the maxillary arch dimensions between time points. Results: Both sides of the cleft width, premaxilla deviation, and premaxilla protrusion had significantly reduced with the use of KKU-NAM. Premaxillary rotation had significantly improved, whereas the arch depth did not change significantly. Premaxilla width, posterior arch width, alveolar length, and height had significantly increased. The anterior arch width, intercanine width, and lateral sulcus width showed no significant changes. The intraclass correlation coefficient used to test the measurements indicated substantial reliability. Conclusion: The modified KKU-NAM is an effective device for reducing the severity of bilateral cleft deformities, especially in the premaxilla area.

Archform in Cleft Palate – A Computerized Tomographic Classification

2006 ◽  
Vol 30 (2) ◽  
pp. 131-134
Author(s):  
S. Pandey ◽  
R. Pandey ◽  
S. Bhatnagar ◽  
K. Pradhan ◽  
R. Pradhan ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Prospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pediatric Dentistry ◽  
Arch Form ◽  
Computer Tomograph ◽  
Medical College ◽  
Arch Forms ◽  
Maxillary Arch

This prospective study was conducted in King George's Medical College, Lucknow, India amongst fifty cleft lip and palate cases to study the various archforms. The maxillary arch form was traced from Computer Tomograph sections of all the cases pre and post-operatively. The various patterns of arch forms as observed from CT tracings exhibiting U & V shaped with sub-types denominated as posteriorly – convergent (c), divergent (d) and parallel (p). This simplified classification can be used in pediatric dentistry practice.

A Randomized Prospective Clinical Trial of the Effect of Infant Orthopedics in Unilateral Cleft Lip and Palate: Prevention of Collapse of the Alveolar Segments (Dutchcleft)

2003 ◽  
Vol 40 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Charlotte Prahl ◽  
Anne M. Kuijpers-Jagtman ◽  
Martin A. van't Hof ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Significant Group ◽  
Arch Form ◽  
Arch Forms ◽  
First Year Of Life ◽  
Infant Orthopedics ◽  
Maxillary Arch

Objective To study the effect of infant orthopedics (IO) on maxillary arch form and position of the alveolar segments. Design Prospective two-arm randomized, controlled trial in parallel with three participating academic cleft palate centers. Treatment was assigned by means of a computerized balanced allocation method. Setting Cleft palate centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients, Participants Infants with complete unilateral cleft lip and palate and no other malformations. Interventions One group (IO+) wore passive maxillary plates during the first year of life; the other group (IO−) did not. All other interventions were the same. Main Outcome Measure(s) The presence of contact and/or overlap (collapse) between the maxillary segments at maxillary casts made shortly after birth, at 15, 24, 48, 58, and 78 weeks. Survival experience of contact and collapse with time as well as the frequencies of different arch forms and severity of collapse were evaluated. Results Comparable arch forms with no contact or overlap of the maxillary segments were seen at birth in both groups. With time the frequency of collapse increased, with no significant differences between groups. No significant group differences were found with respect to the survival experience of contact and collapse or for the severity of collapse at the end of the observational period. Conclusions Infant orthopedics does not prevent collapse and can be abandoned as a tool to improve maxillary arch form.

Evaluation of the Clinical Effectiveness of Nasoalveolar Molding (NAM) Using Grayson Method Versus Computer-Aided Design NAM (CAD/NAM) in Infants With Bilateral Cleft Lip and Palate: A Randomized Clinical Trial

2021 ◽  
pp. 105566562199015
Author(s):  
Noha A. El-Ashmawi ◽  
Mona M. Salah Fayed ◽  
Amr El-Beialy ◽  
Khaled H. Attia
Keyword(s):  
Computer Aided Design ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Comparative Trial ◽  
Clinical Effectiveness ◽  
3 Dimensional ◽  
Computer Aided ◽  
Aided Design ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: The aim is to compare between the clinical effectiveness of nasoalveolar molding (NAM) versus the computer-aided design NAM (CAD/NAM) in patients with bilateral clefts. Design: The trial is a randomized comparative trial with 1:1 allocation ratio. Participants: Thirty infants with bilateral complete cleft lip and palate were recruited. Interventions: Patients were randomized between NAM and CAD/NAM groups. The treatment steps described by Grayson were followed for the NAM group. In the CAD/NAM group, digitized maxillary models were made to create series of modified virtual models which were used to fabricate the molding plates using 3-dimensional printing technology. The nasal stents were then added to the plates following Grayson method. The study lasted for 4 months. Main Outcomes: The primary outcome was to evaluate the changes in the intersegment cleft gap. Secondary outcomes included the analysis of the maxillary arch in transverse, anteroposterior, and vertical dimensions as well as the premaxillary deviation and rotation. Chair side time was assessed for both methods. Results: Both modalities decreased the intersegment cleft gap. The CAD/NAM plates caused more reduction in the total arch length by 1.99 mm (−3.79 to 0.19, P = .03) as compared to the NAM treatment. No differences were found between groups in the transverse and vertical maxillary arch changes. Conclusions: Both interventions were effective in narrowing the cleft gap. Similar maxillary changes were found in both groups. The CAD/NAM modality required less chair side time compared to the NAM treatment.

Effectiveness of a Novel 3D-Printed Nasoalveolar Molding Appliance (D-NAM) on Improving the Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate Infants: A Randomized Controlled Trial

2020 ◽  
Vol 57 (12) ◽  
pp. 1370-1381
Author(s):  
Mohamed Abd El-Ghafour ◽  
Mamdouh A. Aboulhassan ◽  
Mona M. Salah Fayed ◽  
Amr Ragab El-Beialy ◽  
Faten Hussein Kamel Eid ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Outcomes Measures ◽  
Virtual Appliance ◽  
3D Printed ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: The aim of the current study was to introduce and measure the effectiveness of a new 3D-printed nasoalveolar molding (D-NAM) appliance on improving the maxillary arch dimensions (MADs) in infants with unilateral complete cleft lip and palate (UCLP) before surgical lip repair. Design: A prospective, balanced, randomized, parallel groups, single-blinded, controlled trial. Setting: All the steps of the current study were carried in the Department of Orthodontics, Cairo University in Egypt. Participants: Thirty-four, nonsyndromic infants with UCLP. Interventions: The eligible infants were randomly assigned into either no-treatment (control) or to the new D-NAM groups. In D-NAM group, the maxillary models were 3D scanned into virtual models onto which segmentation and alveolar segments approximation were performed. Approximation movements were divided into 3 models representing 3 activation steps. On each of these models, virtual appliance construction was performed followed by 3D printing of the appliance. Nasal stent was added manually to the appliances of the second and third steps. Horizontal tapes were applied to infants in the D-NAM group only. Main Outcomes Measures: A Blinded assessors carried all the MADs measurements virtually on digital models collected at the beginning (T1) and after (T2) treatment. Results: Clinically and/or statistically significant improvements in all the measured MADs were recorded in D-NAM group at T2 before surgical lip repair in comparison to control group. Conclusions: The introduced D-NAM/3D-printed appliance is a simple and efficient technique to improve the MADs in infants with UCLP before surgical lip repair.

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