Taori Kushal P, Niranjane Priyanka, Kamble Ranjit
Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India.
Int J Clin Pediatr Dent. 2024 Aug;17(8):955-961. doi: 10.5005/jp-journals-10005-2899.
In presurgical infant orthopedics, nasoalveolar molding (NAM) therapy has gained more popularity worldwide in treating patients with cleft lip and palate because of its soft tissue nasal corrections in addition to the alignment and close approximation of the cleft alveolar segments, which gives better postsurgical stability and esthetics with minimal tissue tension and scar formation to the patients.The clinical case report aims to show the better post-NAM results, which had helped to gain better postsurgical results in terms of stability and aesthetics in hard and soft tissues.
This clinical report presents the case of a 9-day-old female patient reported in the Department of Orthodontics and Dentofacial Orthopedics at Sharad Pawar Dental College and Hospital with nonsyndromic complete left-sided unilateral cleft lip and palate with a defect size of 13 mm, which was treated with a presurgical nasoalveolar molding (PNAM) appliance. NAM therapy takes advantage of circulating maternal estrogen, bringing pliability to the cartilage cells for presurgical cartilage molding. This has resulted in the closure of the alveolar defect from 13 mm to <2 mm in the present case, with nasal symmetry restoration due to nasal stent within 12 weeks of active treatment; hence, the postsurgical esthetics are maintained.
NAM therapy remained beneficial and had significant aesthetic results in reducing the cleft defect size. Because of this, it gained a big surgical advantage in reducing tissue tension, primary stability, and scar formation.
By reducing the cleft defect size of the dysplastic maxillae, which brings the lip segments and alveolar segments closer to each other, it thus reduces the defect size for primary lip and palate repair. This serves as the biggest advantage for maxillofacial and plastic surgeons to maintain the posttreatment results with redefined aesthetics and symmetry.
Taori KP, Niranjane P, Kamble R. Presurgical Nasoalveolar Molding and Columella Lengthening for Early Unilateral Cleft Lip and Palate Rehabilitation: A Comprehensive Clinical Case Report. Int J Clin Pediatr Dent 2024;17(8):955-961.
在术前婴儿整形外科中，鼻牙槽塑形（NAM）疗法在全球范围内越来越受欢迎，用于治疗唇腭裂患者，因为它除了能使腭裂牙槽段对齐并紧密贴合外，还能对软组织进行鼻部矫正，从而为患者提供更好的术后稳定性和美观效果，同时使组织张力和瘢痕形成最小化。本临床病例报告旨在展示NAM术后更好的效果，这有助于在硬组织和软组织的稳定性及美观方面获得更好的术后效果。
本临床报告介绍了一名9天大的女性患者，该患者在沙拉德·帕瓦尔牙科学院和医院的正畸与牙颌面正畸科就诊，患有非综合征性左侧完全性单侧唇腭裂，缺损大小为13毫米，接受了术前鼻牙槽塑形（PNAM）矫治器治疗。NAM疗法利用母体循环雌激素，使软骨细胞具有柔韧性，以进行术前软骨塑形。在本病例中，这使得牙槽缺损从13毫米缩小至小于2毫米，并且在积极治疗的12周内，由于鼻支架的作用，恢复了鼻对称性；因此，维持了术后美观效果。
NAM疗法仍然有益，并且在减小腭裂缺损大小方面具有显著的美学效果。因此，它在降低组织张力、实现初期稳定性和减少瘢痕形成方面具有很大的手术优势。
通过减小发育不良上颌骨的腭裂缺损大小，使唇部和牙槽段彼此更接近，从而减小了一期唇腭裂修复的缺损大小。这是颌面外科医生和整形外科医生维持具有重新定义的美学和对称性的治疗后效果的最大优势。
陶里·KP、尼兰贾内·P、坎布尔·R。术前鼻牙槽塑形和鼻小柱延长术用于早期单侧唇腭裂修复：一份综合临床病例报告。《国际临床儿科牙科杂志》2024年；17（8）：955 - 961。
