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Presurgical Nasoalverolar Molding in Fraternal Twins with Bilateral Cleft Lip and/or Palate: A Case Report

  • Journal of the Korean academy of pediatric dentistry
  • Abbr : J Korean Acad Pediatr Dent
  • 2014, 41(1), pp.72-79
  • DOI : 10.5933/JKAPD.2014.41.1.72
  • Publisher : The Korean Academy Of Pediatric Dentistry
  • Research Area : Medicine and Pharmacy > Dentistry

김진선 1 김영진 2 NAM Soon-Hyeun 2 Kim, Hyun - Jung 2

1경북대학교 치의학전문대학원 소아치과학교실
2경북대학교

Accredited

ABSTRACT

Cleft lip and palate(CLP) is one of the most common craniofacial deformities that requires systemic managementinvolving a multidisciplinary team approach. Although there has been great improvement in the field of cleftsurgery, surgical approach alone cannot resolve the various problems in treating cleft lip and palate. Hence theneed for presurgical treatment was appreciated and especially, the concept of presurgical nasoalveolar moldingwas applied to treat unilateral and bilateral cleft lip and palate patients. Presurgical nasoalveolar molding(PNAM) of unilateral cleft mainly aims to recover nasal symmetry while theobjectives of pre-surgical nasoalveolar molding in the bilateral cleft are to elongate the columella, to erect the tipof nose, and to reposition the forward displaced premaxillary region. This report covers the case of fraternal twins diagnosed with bilateral cleft. Retraction of the premaxillaryregion and nasoalveolar molding were conducted for 70 days until cheiloplasty, using elastic bands andnasoalveolar molding appliances. After cheiloplasty, there had been improvements in the length of columella andthe position of forward-displaced premaxilla for both patients compared to their initial states. The esthetics wasalso satisfactory for both the surgery and the parents. In order to maximize the efficacy of the appliance, threecomponents should be in balance; patients’adaptation to the appliance, parents’cooperation and proper selectionand careful adjustment of the appliance by the dentist.

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