Primary care in early cleft lip and palate rehabilitation: A dental perspective.

J Family Med Prim Care

Department of Prosthodontics and Crown & Bridge, Goa Dental College and Hospital, Bambolim, Goa, India.

Published: March 2022

Oro-facial clefts are among the most commonly occurring congenital defects. Surgical interventions are commonly carried out to treat these deformities. Some inadequacies however, like scarring of the nasolabial complex and multiple interventions to achieve desired results still persist. Presurgical Nasoalveolar molding (PNAM) technique can be carried out before surgical repair, to facilitate a reduction in the severity of the cleft by actively molding and repositioning the clefted alveolar segments and the associated soft tissues. This case series describes the successful rehabilitation of two unilateral mid-facial cleft babies using the PNAM technique in a step wise manner with a two year follow up.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9051670PMC
http://dx.doi.org/10.4103/jfmpc.jfmpc_990_21DOI Listing

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Article Synopsis
  • Presurgical nasoalveolar molding (PNAM) devices are used to prepare infants with cleft lip for optimal surgical results, and this study focused on analyzing their effectiveness using 3D scanning technology.
  • The research involved 15 patients with unilateral cleft lip and palate, comparing 3D scans of their faces before and after PNAM treatment to measure various nasal and lip features.
  • Results showed significant improvements in several parameters, including increases in the columellar angle and decreases in cleft gap and nostril curvature, indicating that PNAM effectively enhances the surgical outcomes for these patients.
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Modified indigenous nasal elevator for cleft lip and palate patient: A novel clinical innovation.

Med J Armed Forces India

June 2024

Associate Professor, Department of Dental Surgery & Oral Health Sciences, Armed Forces Medical College, Pune, India.

Pre-nasoalveolar molding (PNAM) was developed to reduce the severity of the initial cleft alveolar and nasal deformity. The nasoalveolar moulding appliance (NAM) consists of an intraoral moulding plate with nasal stents to mould the alveolar ridge and nasal cartilage concurrently. Use of the NAM technique also reduces surgical columella reconstruction and the resultant scar tissue in bilateral cleft lip and palate.

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Aim: Presurgical Nasoalveolar molding (PNAM) is a technique used for cleft lip and palate patients prior to cheiloplasty. However, concerns exist regarding its negative impact on maxillary arch growth.This study aimed to assess the effect of selective trimming in NAM on maxillary arch growth in patients with unilateral cleft lip palate.

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Comparison of craniomaxillofacial morphology in children with unilateral cleft lip and palate treated with/without presurgical nasoalveolar molding - a retrospective study with a mean age of 5 years.

Clin Oral Investig

May 2024

Department of Orthodontics, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei, 430079, People's Republic of China.

Objectives: To three-dimensionally assess differences in craniomaxillofacial skeletal development in patients with operated unilateral cleft lip and palate (UCLP) treated with/without presurgical nasoalveolar molding (PNAM) with a mean age of 5 years.

Materials And Methods: Cone-beam CT radiographs of 30 patients with UCLP who had undergone PNAM and 34 patients with UCLP who did not receive PNAM were analyzed. The data were stored in DICOM file format and were imported into the Dolphin Imaging program for 3D image reconstruction and landmark identification.

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Objective: Evaluate facial changes after Presurgical Naso-Alveolar Molding (PNAM) in unilateral cleft lip and palate (UCLP) patients treated with Modified Grayson Technique and AlignerNAM (with DynaCleft nasal elevator) using a 3D facial scan.

Design: Randomised clinical trial.

Setting: Institutional study.

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