Serap Titiz M.S - Speaker - Dentistry 2018
Dr. Serap Titiz
Graduated from Hacettepe University Faculty of Dentistry in 2002. She started his postgraduate education in 2012 at Ege University Faculty of Dentistry Department of Orthodontics and completed his PhD in 2012. She was appointed Assistant Professor in Orthodontics at Usak University Faculty of Dentistry since 2017.
A New Approach in Presurgical Nasoalveloar Molding Treatment in the Management of Cleft Lip and Palate Patients
Objective: Many techniques have been used to align cleft alveolar segments and reduce cleft severity in cleft lip and palate patients The Grayson technique is a well-known technique that has undergone several modifications. The aim of this study was to present a new approach to PNAM for bilateral and unilateral cleft lip and palate patients.
Material Method: In unilateral cleft lip and palate patients modified nostril retainers manufactured from soft acrylic were used instead of nasal stents for nasal molding which enables the separation of the nasal molding and intraoral plate insertion. Modified nostril retainers were used before reducing cleft width to 5mm. In bilateral cleft lip and palate patients the modified PNAM appliance consisted of the retention arm, the
prefabricated retraction apparatus, the nasalstent and the lip hanger fixed to the premaxilla with a band. A combination elastic band system was used to correct the deviation of the premaxilla.
Conclusion: In unilateral cleft lip and palate patients different from the nasal stents in Grayson technique, the modified nostril retainers apply upward and forward forces to both sides of the columella that can accelerate the uprigthing and lengthening of the columella. In bilateral cleft lip and palate patients modified PNAM enabled faster de-rotation of the premaxilla and earlier initiation of retraction. In the modified methods the short duration of the treatment can prevent memory fixation of the cartilage and tissue.