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Effects of Active Presurgical Orthopaedics Appliances in Infants With Complete Unilateral Cleft Lip and 'T-Shaped'
Trang Thi-Huyen Nguyen1,2, Thuy-Trang Thi Ho1, Dau Van Nguyen3
1Department of Orthodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Insights
Active presurgical orthopaedics appliances significantly improved nasal and alveolar deformities in infants with complete unilateral cleft lip. This treatment offers a promising approach for managing T-shaped alveolus in newborns.
Area of Science:
- Craniofacial Surgery
- Pediatric Dentistry
- Orthodontics
Background:
- Infants with complete unilateral cleft lip often present with significant nasal and alveolar deformities.
- The T-shaped alveolus, characterized by overlapped alveolar segments, poses a unique challenge in managing cleft lip cases.
- Presurgical orthopaedics aims to improve the anatomical structures before surgical repair.
Purpose of the Study:
- To evaluate the effectiveness of active presurgical orthopaedics appliances in infants with complete unilateral cleft lip and T-shaped alveolus.
- To quantify the changes in nasal and alveolar morphology following active presurgical orthopaedics treatment.
Main Methods:
- A retrospective and prospective longitudinal study involving 40 infants with complete unilateral cleft lip and T-shaped alveolus.
- Treatment with active presurgical orthopaedics appliances for an average of 3 months.
- Nasal and alveolar casts were scanned and analyzed using 3D intraoral scanners and specialized software.
Main Results:
- Statistically significant improvements were observed in nostril height (increased by 2.62 mm) and reduction in columella deviation (-23.45°).
- Significant reduction in cleft gap (-3.77 mm) and alveolar overlap (-3.71 mm) was noted.
- Growth of the cleft segment increased by 2.27 mm, and rotation of the non-cleft alveolus decreased by -5.29°.
Conclusions:
- Active presurgical orthopaedics appliances are effective in correcting nasal deformities in infants with complete unilateral cleft lip.
- The appliances significantly improve the morphology of the overlapped alveolus in cases of T-shaped alveolus.
- This treatment modality demonstrates positive outcomes for managing complex cleft lip and palate presentations.
Objectives:
This study aimed to assess the efficacy of active presurgical orthopaedics appliances in infants presenting with complete unilateral cleft lip and overlapped alveolus (T-shaped alveolus).
Materials And Methods:
A retrospective and prospective longitudinal study was performed. Infants diagnosed with complete unilateral cleft lip and overlapped alveolus, received treatment with the active presurgical orthopaedics appliances from June 2020 to June 2023, at Children's Hospital 1, Ho Chi Minh City. The treatment duration averaged 3 months. Pre- and posttreatment casts of noses and alveolus were scanned using TRIOS3 Wireless intraoral scanner (3Shape, Denmark) and analysed with Slicer 5.2.2 software. There were 16 quantitative variables. A pair t-test and Wilcoxon signed ranks were used for analysis. The statistical significance was adopted as p < 0.05.
Results:
A total 40 patients (17 males, 23 females, mean age 23.85 ± 19.22 days) were evaluated. After treatment, the nostril height increased by 2.62 ± 0.22 mm and the deviation columella decreased by -23.45° ± 2.29°. There was a reduction in cleft gap (-3.77 ± 2.01 mm), and in the overlap of alveolus (-3.71 ± 1.83 mm), the growth of cleft segment increased by 2.27 ± 2.00 mm, while the rotation of the noncleft side alveolus decreased by -5.29° ± 5.31°. The changes were statistically significant (p < 0.001).
Conclusions:
Active presurgical orthopaedics appliances improved the nasal deformity and overlapped alveolus morphology in infants with complete unilateral cleft lip and T-shaped alveolus.
