Isogawa Nobutaka, Ochiai Satoru, Mito Toshinori, Kindaichi Junko, Ishibashi Naho, Takagi Yuzo, Ishikawa Masaaki
Dental Clinic, Kameda Hospital, Chiba, Japan.
Singapore Dent J. 2010 Jun;31(1):36-42. doi: 10.1016/S0377-5291(12)70008-1. Epub 2012 Jan 25.
The presurgical nasoalveolar molding plate appliance with stent (PNAM) extended from the palatal molding plate; to correct the nostril shape of infants with cleft lip and palate is well known. The PNAM appliance is based on the finding that a high degree of plasticity is maintained in the cartilage of infants during the first 6 weeks after birth. However, on the current PNAM protocol described by Grayson et al. the nasal stent is supposed to be an adjunct to the palatal molding plate after reducing the severity of the alveolar cleft width. We have used the modified Hotz's plate from the setup model and built up the nasal stent even before reducing the severity of the alveolar deformity. In this study we assess the effects of the modified Hotz's plate and the modified PNAM appliance for the alveolar and palatal form. The lateral deviation of the incisal point, the width of the palatal cleft, and the degree of curvature of the palatal vault were first evaluated on plaster models. The PNAM group is smaller on the lateral deviation of the incisal point than the modified Hotz's group. The decreased average width of the palatal cleft and curvature of the palate, was almost the same in both the modified Hotz's and PNAM groups. In comparison with the modified Hotz's plate, the modified PNAM appliance also improves the molding of the alveolar segments and reduces cleft width.
带有支架的术前鼻牙槽塑形板矫治器（PNAM）从腭部塑形板延伸而来，用于矫正唇腭裂婴儿的鼻孔形状，这是众所周知的。PNAM矫治器基于这样一个发现，即婴儿出生后的前6周内，其软骨保持着高度的可塑性。然而，根据格雷森等人描述的当前PNAM方案，鼻支架在减轻牙槽裂宽度的严重程度后，应作为腭部塑形板的辅助装置。我们从模型设置中使用了改良的霍茨板，甚至在减轻牙槽畸形的严重程度之前就构建了鼻支架。在本研究中，我们评估了改良的霍茨板和改良的PNAM矫治器对牙槽和腭部形态的影响。首先在石膏模型上评估切牙点的侧向偏移、腭裂宽度和腭穹隆的弯曲程度。PNAM组切牙点的侧向偏移比改良霍茨组小。改良霍茨组和PNAM组腭裂平均宽度的减小以及腭部弯曲程度几乎相同。与改良的霍茨板相比，改良的PNAM矫治器还改善了牙槽段的塑形并减小了裂隙宽度。
