Design of a Novel Orthodontic Appliance to Prevent Pedicle Trauma in Patients Undergoing Double-Opposing Buccal Flaps for Palatal Lengthening.

Objective: To describe a novel orthodontic appliance to prevent pedicle trauma in patients undergoing double-opposing buccal flap surgery for secondary palatal lengthening.

Design: Case series.

Setting: Cleft and craniofacial clinic, Johns Hopkins Children's Center.

Patients, Participants: Four patients undergoing double-opposing buccal flap surgery for repair of velopharyngeal insufficiency.

Interventions: Patients were fitted with the device, which consists of a lower lingual holding arch with acrylic bite blocks.

Main Outcome Measure: Presence of pedicle trauma postsurgery and tolerability of the device.

Results: The appliance was well tolerated in all 4 patients and no biting trauma to the pedicles was observed.

Conclusions: A reliable appliance has been developed to prevent biting trauma to the pedicles in patients undergoing double-opposing buccal flap surgery in the permanent dentition stage.