The Impacts and Outcomes of Presurgical Nasoalveolar Molding (PNAM) in Newborn Sequential Therapeutic Implementation

2021 ◽  
Author(s):  
Vonda Trivosa
Keyword(s):  
Incidence Rate ◽  
Rural Areas ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Parents And Children ◽  
Nasoalveolar Molding

Cleft lip and palate is a common congenital malformation in the oral and maxillofacial regions. According to epidemiological investigation, the incidence rate is about 1.625%, and the incidence rate is high in poor areas and rural areas. Cleft lip and palate mainly involve the upper lip, hard palate, soft palate and nose, which can damage the appearance of children, affect pronunciation, swallowing and chewing, and also bring different degrees of psychological damage to children in the growth stage. Therefore, we should actively carry out sequential treatment and participate in the treatment work through multi-disciplines. Based on restoring the oral and maxillofacial function and health of children, we should also pay attention to their aesthetic needs, enhance the treatment confidence of parents and children, and lay the foundation for the follow-up repair treatment. Most patients with cleft lip and palate are complicated with malocclusion. Orthodontic treatment is an important part of the treatment of cleft lip and palate. The orthodontic treatment of cleft lip and palate can be divided into five periods: newborn period, deciduous dentition period, mixed dentition period, permanent dentition period and combined orthodontic and orthognathic treatment period. Presurgicalnasoalveolar molding (PNAM) was used to reduce the severity of facial deformity in children with cleft lip and palate. This article discusses the therapeutic effect of newborn PNAM according to clinical cases. Objective to study the opportunity and current situation of PNAM in the treatment of children with cleft lip and palate, and to provide a favorable reference for clinical orthodontists, emphasizing the close communication between various disciplines.

Orthodontic Treatment of Malocclusion Associated with Repaired Complete Clefts of the Lip and Palate

1979 ◽  
Vol 6 (2) ◽  
pp. 73-83 ◽  
Author(s):  
W. C. Shaw
Keyword(s):  
Soft Tissue ◽  
Treatment Planning ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Arch Form ◽  
Progressive Development ◽  
General Care

The literature concerning orthodontic treatment of malocclusion associated with cleft lip and palate has been reviewed. The aims of treatment and a number of skeletal, soft tissue, dento-alveolar and general care factors which influence treatment planning are discussed. The effect of early orthopaedic treatment, examined solely on the grounds of eventual arch form in the deciduous dentition, reveals a prophylactic benefit in some, but not all reports. There would appear to be little benefit in carrying out orthodontic treatment in the deciduous dentition but it is suggested that the progressive development of severe overclosure during the mixed dentition phase should be intercepted using simple appliances. The most important phase of treatment follows eruption of the permanent dentition and appliances are described which are capable of substantial radial and vertical corrections in preparation for a permanent prosthesis.

Orthopedic Protraction of the Upper Jaw in Cleft Lip and Palate Patients during the Deciduous and Mixed Dentition Periods in Comparison with Normal Growth and Development

1993 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh ◽  
Olav E. Bøe
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Growth ◽  
Mixed Dentition ◽  
Deciduous Dentition ◽  
Lower Jaw ◽  
Lateral Cephalograms ◽  
Anterior Position ◽  
Upper Jaw ◽  
Posterior Position

Cleft lip and palate (CLP) patients often develop maxillary retrusion after cleft repair. Since 1977, a group of 98 cases with negative overjet (anterior crossbite) during the period of deciduous dentition has been treated by the Bergen CLP team. The purpose of treatment has been to achieve favorable occlusion with positive overjet and overbite by means of anterior orthopedic traction (protraction). The average age at start of treatment was 6 years 11 months, and mean treatment duration was 13 months. The protraction force was 700 g. The serial lateral cephalograms of the treated CLP group were compared with those of a noncleft group with normal growth. Normalization of the sagittal maxillomandibular relationship (ANB angle) was achieved. Significant changes were a more anterior position of the upper jaw, and a more posterior position of the lower jaw, due to mandibular clockwise rotation. The variation was considerable. This paper reports the overall changes in the whole CLP group (ALL-C group).

scholarly journals Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

2020 ◽  
Vol 9 (2) ◽  
pp. 576
Author(s):  
Yu-Ying Chu ◽  
Frank Chun-Shin Chang ◽  
Ting-Chen Lu ◽  
Che-Hsiung Lee ◽  
Philip Kuo-Ting Chen
Keyword(s):  
Bone Grafting ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Prospective Trial ◽  
Mixed Dentition ◽  
Alveolar Bone Grafting ◽  
Significant Difference ◽  
Secondary Alveolar Bone Grafting

Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.

scholarly journals Association of the profile of individuals with cleft lip/palate with the beginning of orthopedic/ orthodontic treatment

RSBO ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 86-93
Author(s):  
Madiana Magalhães Moreira ◽  
Pedro Diniz Rebouças ◽  
Maria Lúcia Bonfim Chagas ◽  
Luan Cartaxo Félix ◽  
Paulo Goberlânio de Barros Silva ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Geographic Origin ◽  
Panoramic Radiograph ◽  
Mixed Dentition ◽  
Chi Square ◽  
Reference Hospital ◽  
Cleft Lip Palate ◽  
Chi Square Test

Cleft lip and palate (CLP) is the most frequent congenital malformation among the anomalies of the head and neck. The orthopedic/orthodontic treatment is included in the rehabilitation of these individuals, however there is no consensus in the literature regarding the ideal time for its beginning. Objective: To verify and characterize the profile of individuals with CLP treated at a reference hospital of the northeast of Brazil from 1998 to 2013 and its association with the beginning of the orthopedic/ orthodontic treatment. Material and methods: Through direct observation of medical records, panoramic radiograph, and study casts of 323 individuals, data regarding sex, cleft type, origin and age of beginning of the orthopedic/orthodontic treatment were surveyed and analyzed using the chi-square test, considering a 5% level of significance. Results: Most of the individuals had transforamen and the unilateral cleft was the most prevalent (p<0.05). Females were statistically more affected by post-foramen cleft and males by trans-foramen cleft (p><0.05). Most individuals with trans-foramen cleft and post-foramen cleft started the orthopedic/ orthodontic treatment between 8 and 12 years old (p><0.05). No statistically significant differences occurred relating the beginning><0.05). Females were statistically more affected by post-foramen cleft and males by trans-foramen cleft (p<0.05). Most individuals with trans-foramen cleft and post-foramen cleft started the orthopedic/ orthodontic treatment between 8 and 12 years old (p<0.05). No statistically significant differences occurred relating the beginning> <0.05). No statistically significant differences occurred relating the beginning of the orthopedic/orthodontic treatment with geographic origin and sex of, although most of them have started treatment at late mixed dentition. Conclusion: Regardless of gender, origin, or cleft type, most patients started orthopedic treatment up to 12 years-old, an age considered ideal by most protocols. Unilateral and trans-foramen cleft were the most prevalent cleft types. post-foramen cleft affected more females, while trans-foramen cleft affected more males.

scholarly journals Surgical-orthodontic treatment for severe malocclusion in a patient with osteopetrosis and bilateral cleft lip and palate: Case report with a 5-year follow-up

2021 ◽  
Author(s):  
Jin-Kyu Kim ◽  
Jun-Young Kim ◽  
Hwi-Dong Jung ◽  
Young-Soo Jung
Keyword(s):  
Functional Outcomes ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chief Complaint ◽  
Radiographic Evaluation ◽  
Bone Metabolism Markers ◽  
Normal Bone ◽  
Bilateral Cleft Lip

ABSTRACT Orthognathic surgery in patients with craniofacial osteopetrosis, a condition associated with osteoclast dysfunction, is usually avoided because of the risk of osteomyelitis. A 19-year-old woman presented with the chief complaint of severe malocclusion and anterior crossbite. After radiographic evaluation, craniofacial osteopetrosis was diagnosed. Surgical-orthodontic treatment was performed after meticulous history taking and verification of normal bone turnover using bone-metabolism markers for endocrine evaluation. Favorable esthetic and functional outcomes were achieved.

scholarly journals The First-Year Follow-Up of a Cleft Lip and Palate Patient Treated With Nasoalveolar Molding (NAM)

2020 ◽  
Vol 31 (2) ◽  
pp. 190-196
Author(s):  
Nathália Viegas de Oliveira ◽  
Gabriel Antônio Anjos Tou ◽  
Raquel Souto Silva ◽  
Sérgio Edriane Rezende ◽  
Henrique Pretti ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Primary Repair ◽  
Operative Therapy ◽  
First Year ◽  
Treatment Morbidity ◽  
One Step ◽  
Nasoalveolar Molding

Abstract The objectives of pre-surgical orthopedics are to allow surgical repair with minimal tension of the involved tissues and less restriction to the craniofacial growth. The aim of this study was to evaluate the benefits of nasoalveolar model (NAM) as a pre-operative therapy in a patient with bilateral cleft lip and palate followed by labioplasty and palatoplasty. A 15-day-old patient underwent orthopedic treatment with NAM. After pre-operative treatment, retraction of the pre-maxilla was observed with reduction of the fissure. Due to the successful effects of NAM treatment the patient had a one-step surgery for lip correction. Six months later, due to lip pressure the fissure was further decreased. After six months, the patient underwent palatoplasty. Both surgeries contributed to the remaining closure of the fissure, which were reduced by half compared to the end of pre-operative treatment. The uses of NAM as a pre-operative treatment approached the alveolar segments, centralized the pre-maxilla, decreased the cleft palate resulting in a marked improvement of the arch and provide superior surgical results. In addition, it allows the primary repair of the patient’s lip with asymmetric bilateral fissure in only one-step surgery; in consequence, it will reduce treatment morbidity and decrease cost of treatment.

Protração maxilar ancorada em miniplacas na fissura labiopalatina – do diagnóstico à maturidade esquelética

2021 ◽  
Vol 14 (54) ◽  
pp. 80-88
Author(s):  
Renata Mayumi Kato ◽  
Renato André de Souza Faco ◽  
Hilde Timmerman ◽  
Hugo De Clerck ◽  
Daniela Garib
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Full Time ◽  
Class Iii ◽  
Facial Growth ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting

The purpose of this study was to report a case with complete unilateral cleft lip and palate (CLP) treated with bone anchored maxillary protraction (BAMP) in miniplates followed up until the end of facial growth. A 7-year-old girl with complete left side CLP started the orthodontic treatment in a rehabilitation center. She presented a Class III skeletal pattern due to maxillary deficiency, a GOSLON 4 sagittal interarch relationship, a negative overjet of 1.5mm and agenesis of left upper lateral incisor. In the mixed dentition, the patient was submitted to rapid maxillary expansion followed by the secondary alveolar bone grafting procedure. At 12y 3m two miniplates were installed in the maxilla and two in the mandible with BAMP therapy. The patient was instructed to use full time Class III elastics with force of 250g/side together with a bite lifting plate in the upper arch. BAMP therapy duration was 19 months leading to a positive overjet and GOSLON 1 sagittal interarch relationship. The cephalometric analysis demonstrated a mild maxilla advancement. Class III elastics started to be used only at night as an active retention concomitantly with Phase II orthodontic treatment. Compensatory corrective orthodontic treatment established adequate occlusion between the dental arches with significant improvement of facial aesthetics after the intervention. Le Fort 1 surgery with maxillary advancement was not necessary.

Perawatan Komprehensif Geligi Campuran pada Anak Usia 8 Tahun dengan Riwayat Ibu memiliki Celah Bibir – Laporan Kasus

2020 ◽  
Vol 3 (2) ◽  
pp. 1
Author(s):  
Anisa Nursantika ◽  
Jeffrey Jeffrey
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Amalgam Restoration ◽  
Dental Hospital ◽  
Orofacial Region ◽  
Left And Right ◽  
Lower Arch

<p align="center"><strong><em>Abstract</em></strong></p><p><strong><em>            </em></strong><em>Cleft lip and palate are abnormal clefts in the orofacial region that affect lip, alveolar bone, hard palate, and or soft palate. An eight-year-old girl came to Dental Hospital of Unjani with her mother, with chief complaint tooth cavity on the left and right of the lower arch and want to be treated. Intraoral findings found that the patient’s teeth are crowded with a narrow jaw arch. From the anamnesis, the mother of the patient had a cleft lip and extend to the alveolar bone, but the patient itself has no cleft lip and palate. The comprehensive treatments that done to the patient are amalgam restoration of tooth 75 and pulp capping of tooth 85 with stainless steel crown as follow up restoration.</em></p><p><em> </em></p><em>Keywords: Cleft lip, narrow jaw, mixed dentition treatment</em>

A New Protocol for Maxillary Protraction in Cleft Patients: Repetitive Weekly Protocol of Alternate Rapid Maxillary Expansions and Constrictions

2005 ◽  
Vol 42 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Eric Jein-Wein Liou ◽  
Wen-Ching Tsai
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Mixed Dentition ◽  
Prospective Clinical Study ◽  
Maxillary Expansion ◽  
Treatment Results ◽  
Maxillary Protraction ◽  
Maxillary Advancement

Objective It was hypothesized that, through a repetitive weekly protocol of Alternate Rapid Maxillary Expansions and Constrictions (Alt-RAMEC), the maxilla in cleft patients could be protracted more effectively than with a single course of rapid maxillary expansion (RME). Methods Twenty-six consecutive unilateral cleft lip and palate patients at the age of mixed dentition were included in this prospective clinical study. The rapid maxillary expansion group included the first 16 consecutive patients undergoing 1 week of rapid maxillary expansion (1 mm/day) followed by 5 months, 3 weeks of maxillary protraction. The Alternate Rapid Maxillary Expansions and Constrictions group included the next 10 consecutive patients undergoing 9 weeks of Alternate Rapid Maxillary Expansions and Constrictions followed by 3 months, 3 weeks of maxillary protraction. Daily activation of the weekly expansion or constriction was 1.0 mm. Two-hinged expanders and intraoral maxillary protraction springs were used in both groups. Treatment results were evaluated cephalometrically. Results The amount of maxillary anterior displacement by the 2-hinged expander in the Alternate Rapid Maxillary Expansions and Constrictions group was 3.0 ± 0.9 mm at A point, significantly greater than the 1.6 ± 1.0 mm in the rapid maxillary expansion group. The amount of maxillary advancement with intraoral protraction springs in the Alternate Rapid Maxillary Expansions and Constrictions group was 2.9 ± 1.9 mm at A point, significantly greater than the 0.9 ± 1.1 mm in the rapid maxillary expansion group. The overall amount of maxillary advancement in the Alternate Rapid Maxillary Expansions and Constrictions group was 5.8 ± 2.3 mm at A point. This result remained stable, without significant relapse after 2 years. Conclusions Maxillary protraction using the 2-hinged expander, a repetitive weekly protocol of Alternate Rapid Maxillary Expansions and Constrictions, and intraoral protraction springs is most effective, with stable results at 2-year follow-up.

scholarly journals A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

2020 ◽  
Vol 53 (03) ◽  
pp. 371-376
Author(s):  
Tulasi Nayak ◽  
Renu Parmar ◽  
Krishnamurthy Bonanthaya ◽  
Pritham Shetty
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Conclusive Evidence ◽  
Long Term Stability ◽  
Alar Base ◽  
Gradual Loss ◽  
Nasoalveolar Molding

Abstract Background Nasoalveolar molding (NAM) has been extensively used as a presurgical technique in the treatment of unilateral cleft lip and palate (UCLP) over the last two decades. It has proven to be a useful tool to reduce the cleft size, improve nasal symmetry, and increase the columellar length. The long-term stability of these findings has not been conclusively proven. Methods In this longitudinal study, the nasal symmetry of 24 NAM treated UCLP patients was evaluated to assess the 5-year stability of NAM. The basal photographs were shot postcheiloplasty (T1), at 1-year follow-up (T2), at 3-year follow-up (T3), and 5-year follow-up (T4) appointments. Results In this study, we found that NAM was a useful adjuvant in achieving nasal symmetry in patients with UCLP in the immediate postoperative period. However, as the patients aged, there was a gradual loss of mean nasal height (by 22.83%) and columella length (by 24.89%), a mean gain in nasal width (by 40.25%) and alar base width (by 40.69%), and an increase in the columella deviation (by 3.46%) from the T1 to the T4 follow-up. Conclusion Although there is no conclusive evidence, the loss of symmetry may be due to the unequal growth on the cleft and noncleft sides. These patients will be followed-up till end of growth for a definite conclusion on the long-term effect of NAM.

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