Alternative Method Used to Correct Distorted Neonatal Cleft Arch Forms

Fig. 5.1

(af) The use of an external elastic force to reduce premaxillary protrusion. (a, b) The protruding premaxilla extends forward in the facial profile. (c) Head bonnet with attached elastic placed against the protruding premaxilla causes it to ventroflex with the fulcrum at the premaxillary vomerine suture. (d, e) Facial photographs at 3 years of age. The lateral lip elements are united with the medial positioned prolabium over the protruding premaxilla in one stage. Because the premaxilla is already ventroflexed at the time of surgery, there is reduced ­muscle tension at the suture sites. (f) Intraoral photograph shows excellent anterior and buccal occlusion even with bilateral deciduous cuspids in crossbite. Comment: A severe overbite or overjet with a buccal crossbite at this age does not create a functional dental problem or inhibit palatal growth. Midfacial protrusion is expected and even desirable at this age. A straight profile in the mixed dentition usually indicates a concave profile will develop in adolescence after the pubertal growth spurt
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Fig. 5.2

(af) Case MD (AM-17). Conservative surgery with no presurgical orthopedics in CUCLP. Lip adhesion to start molding action to bring the separated palatal segment together. (a) At birth. (b) After lip adhesion at 5 months. (c) After definitive lip surgery at 9 months. (d, e) Facial appearance at 8 years of age. (f) Occlusion at 8 years. The right deciduous lateral incisor erupted through a secondary alveolar bone graft performed at 7 years of age using cranial cancellous bone
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Fig. 5.3

(ai) Presurgical orthopedic treatment (PSOT) appliance for a CUCLP utilized from birth to 1 year and 11 months at the University of Nijmegen (Courtesy of AM Kuijpers-Jagtman). (a) Lip and nose distortion at birth; (b) tongue posture within the cleft; (c) orthopedic appliance; (d) orthopedic plate prevents the tongue from entering the cleft; (e) 15 weeks after PSOT and before lip closure; (f) 6 weeks after palate closure; (g) 17 months before soft palate closure; (h) at 14 months of age, before soft palate closure; (i

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Oct 18, 2015 | Posted by in General Dentistry | Comments Off on Alternative Method Used to Correct Distorted Neonatal Cleft Arch Forms
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