Hao Jiansuo, Wan Quan, Liu Jiayu, Wu Wenli, Liu Jiameng, Luo Chongdai, Gao Zijun, Li Fan, Chen Yiyang, Lu Zhiyuan
Department of Oral and Maxillofacial Surgery, Stomatology Medical Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
Am J Transl Res. 2022 Jun 15;14(6):3988-3994. eCollection 2022.
To develop a modified presurgical nasoalveolar molding (MPNAM) with a premaxillary appliance, connected with two stainless steel wires and evaluate its therapeutic efficacy in newborns with complete bilateral cleft lip and palate (BCLP).
A total of 41 patients with neonatal complete BCLP having a severely protruded and deviated premaxilla were retrospectively selected from January 2017 to November 2019. All patients received the MPNAM device with a premaxillary appliance which was worn until cheilorrhaphy. Plaster casts from pre- and post-MPNAM treatments were scanned using a three-dimensional laser scanner, and the changes were recorded. Facial photographs of patients were taken during the treatment.
The average MPNAM treatment duration was 59.8 days. In all cases, the protrusive and deviated premaxilla was rapidly retracted and set into a suitable position after MPNAM treatment. The relative deviation distance and alveolar cleft width were significantly reduced. Both mid-palatal arch width and posterior arch width were increased. In addition, none of the patients developed any complications during the MPNAM treatment.
Our MPNAM device was able to rapidly centralize the malpositioned premaxilla and reduce the alveolar cleft defect. This device can be applied in presurgical orthodontic treatments for patients with complete BCLP having a severely protruded and deviated premaxilla.
开发一种改良的术前鼻牙槽塑形（MPNAM）方法，使用与两根不锈钢丝相连的上颌前牵引矫治器，并评估其对双侧完全性唇腭裂（BCLP）新生儿的治疗效果。
回顾性选取2017年1月至2019年11月期间41例患有严重前突和偏斜上颌骨的新生儿完全性BCLP患者。所有患者均接受了带有上颌前牵引矫治器的MPNAM装置，佩戴至唇裂修复术。使用三维激光扫描仪扫描MPNAM治疗前后的石膏模型，并记录变化情况。在治疗期间拍摄患者的面部照片。
MPNAM的平均治疗时长为59.8天。在所有病例中，MPNAM治疗后，前突和偏斜的上颌骨迅速回缩并调整到合适位置。相对偏斜距离和牙槽裂宽度显著减小。腭中弓宽度和后弓宽度均增加。此外，在MPNAM治疗期间，没有患者出现任何并发症。
我们的MPNAM装置能够迅速使错位的上颌骨复位并减少牙槽裂缺损。该装置可应用于患有严重前突和偏斜上颌骨的完全性BCLP患者的术前正畸治疗。
