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Segmental Premaxillary Bowl Cutting as an Alternative PNAM Approach for Extreme Premaxillary Rotation in Bilateral
Gian Nur Alamsyah1, Helmi Siti Aminah2, Yunia Dwi Rakhmatia1
1Department of Prosthodontics, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.
None:
ObjectiveTo evaluate the feasibility of a modified presurgical naso-alveolar molding (PNAM) technique using segmental bowl cutting with contralateral soft-liner augmentation for correcting severely rotated premaxillae in infants with bilateral cleft lip and palate (BCLP).DesignProspective case series.SettingClinical case series conducted over a 2-year period (July 2022-July 2024) at a single center.ParticipantsThree infants diagnosed with BCLP presenting with extreme premaxillary rotation (2 rightward, 1 leftward).ResultsAll 3 premaxillae achieved the predefined midline criterion within 4 to 5 weeks (28-35 days) at an average correction rate of approximately 2 mm per week. No major complications were observed; mild transient mucosal blanching was noted in 2 infants, which resolved with appliance relief.ConclusionsSegmental cutting of the PNAM bowl with contralateral soft-liner augmentation appears to be a feasible and clinically useful adjunct for correcting severely rotated premaxillae prior to labioplasty. These preliminary findings require validation in larger, controlled studies before superiority over conventional PNAM can be established.
