Titiz Serap, Aras Isil
1 Discipline of Orthodontics, Private Practice, Izmir, Turkey.
2 Faculty of Dentistry, Department of Orthodontics, Ege University, Izmir, Turkey.
Cleft Palate Craniofac J. 2018 Oct;55(9):1316-1320. doi: 10.1177/1055665618765781. Epub 2018 Mar 26.
The aim of this study was to evaluate a modified presurgical nasoalveolar molding (PNAM) treatment for patients with bilateral cleft lip and palate (BCLP) with severely malpositioned premaxillae.
This study was conducted at the Faculty of Dentistry, Department of Orthodontics, Ege University, Bornova, Izmir, Turkey.
Retention arms were manufactured using a mold that we developed, and prefabricated retraction apparatuses were applied to the plaster model obtained from the patient. During the acrylic curing process, the flanges of the appliances were elongated into the sulcus without including the premaxilla. The premaxilla was aligned with the midline with an elastic band system, and the lip hanger was constructed with 0.023-in stainless steel wire. Elastic bands were stretched between the retraction apparatuses and the lip hanger based on the desired force. Nasal stents were added to the retention arms when the cleft width was reduced to less than 6 mm.
The modified PNAM treatment enabled faster derotation of the premaxilla and earlier initiation of retraction. The prefabricated retraction apparatus and retention arm provided efficient PNAM for patients with BCLP.
本研究旨在评估一种改良的术前鼻牙槽塑形（PNAM）治疗方法，用于双侧唇腭裂（BCLP）且前颌骨严重错位的患者。
本研究在土耳其伊兹密尔博尔诺瓦市艾杰大学牙科学院正畸科进行。
使用我们开发的模具制作固位臂，并将预制的牵引装置应用于从患者获取的石膏模型上。在丙烯酸固化过程中，矫治器的翼缘延伸至龈沟，不包括前颌骨。使用弹性带系统使前颌骨与中线对齐，并用0.023英寸不锈钢丝制作唇钩。根据所需力量在牵引装置和唇钩之间拉伸弹性带。当腭裂宽度减小至小于6毫米时，在固位臂上添加鼻支架。
改良的PNAM治疗能够使前颌骨更快地复位并更早开始牵引。预制的牵引装置和固位臂为BCLP患者提供了有效的PNAM治疗。
