Monga Nitika, Kharbanda Om P
1 Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Cleft Palate Craniofac J. 2019 Sep;56(8):1115-1119. doi: 10.1177/1055665619833865. Epub 2019 Mar 13.
The neonate premaxilla in bilateral cleft lip and palate is often protruding and displaced laterally. Surgeons prefer the premaxilla to be repositioned and centralized to allow a tension-free primary lip repair. This report describes the fabrication of a premaxillary bonnet appliance with silicone material and its successful use in 2 cases of bilateral cleft lip and palate (BCLP).
PATIENTS, PARTICIPANTS: Two male BCLP patients of ages 34 days and 10 days, respectively.
Nonsurgical repositioning of the premaxillary segment using silicone cup-bonnet appliance.
The duration of active treatment by silicone appliance was 36 days in case 1 and 75 days in case 2. The retention period was 2 months and 3 months, respectively. The appliance made of room temperature vulcanizing (RTV) silicone is flexible and softer in comparison to the rigid conventional acrylic appliance and is therefore almost atraumatic. A gentler appliance resulted in enhanced compliance and acceptance by the neonates. There was a noticeable change in the position of the discernible asymmetric premaxilla. Analysis of frontal facial photographs revealed an angular change in the position of the premaxilla (C) by 12° in case 1 and 6° in case 2 in reference to the midfacial plane.
This silicone appliance provides enhanced compliance and improved retention compared to acrylic appliance since it is a more gentle, flexible, and less traumatic alternative to a rigid acrylic appliance. Further, the RTV silicone appliance can be 3-dimensionally printed for better accuracy following intraoral scanning and thus eliminating the need for impression making in cleft newborns.
双侧唇腭裂新生儿的前颌骨常突出并向外侧移位。外科医生希望将前颌骨重新定位并中心化，以便进行无张力的一期唇修复。本报告描述了一种用硅胶材料制作的前颌骨帽状矫治器及其在2例双侧唇腭裂（BCLP）病例中的成功应用。
患者、参与者：两名男性BCLP患者，年龄分别为34天和10天。
使用硅胶杯状帽矫治器对前颌骨段进行非手术复位。
病例1中硅胶矫治器的积极治疗持续时间为36天，病例2为75天。保持期分别为2个月和3个月。与刚性的传统丙烯酸矫治器相比，由室温硫化（RTV）硅胶制成的矫治器更灵活、更柔软，因此几乎无创伤。更温和的矫治器提高了新生儿的依从性和接受度。可辨别的不对称前颌骨的位置有明显变化。对正面面部照片的分析显示，参照面中平面，病例1中前颌骨（C）的位置角度变化为12°，病例2为6°。
与丙烯酸矫治器相比，这种硅胶矫治器具有更高的依从性和更好的固位性，因为它比刚性丙烯酸矫治器更温和、更灵活且创伤更小。此外，RTV硅胶矫治器可以在口腔内扫描后进行三维打印，以提高准确性，从而消除对唇腭裂新生儿取模的需要。
