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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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Korean J Orthod

Published online July 22, 2021

Copyright © The Korean Association of Orthodontists.

Presurgical Alveolar Molding Treatment of an Infant with Down Syndrome and Tessier No. 0 Cleft: 21 Months' Follow-up

Gonca Mervea, Ozel Mehmet Birolb

aDepartment of Orthodontics, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
bDepartment of Orthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey Corresponding author: Dr. Gonca Merve, Assistant Professor, Department of Orthodontics, Recep Tayyip Erdogan University Faculty of Dentistry, Rize, Turkey

Correspondence to:Merve Gonca
Recep Tayyip Erdogan University, Rize, Turkey
Department of Orthodontics, Faculty of Dentistry
Assistant Professor DDS
Phone: +90 464 222 0000
Fax: +90 464 222 00 02
Email: mervegonca@gmail.com
Mehmet Birol ÖZEL
Kocaeli University, Kocaeli, Turkey
Department of Orthodontics, Faculty of Dentistry
Assistant Professor Ph.D, DDS
Tel: +90 262 344 22 22 – 5168
Fax: +90 262 344 21 09
Email: birolozel@hotmail.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Craniofacial clefts are extremely rare deformities. Tessier’s classification is a widely accepted method that is based on clinical, radiologic, and surgical observations. The Tessier No. 0 cleft most commonly affects the upper lip, the nose, and the palate. The purpose of this case presentation was to report the effects of a modified presurgical alveolar molding (PAM) appliance applied to an infant with Tessier No. 0 cleft and provide an alternative approach for shaping these defects. The modified PAM appliance consisted of reciprocal parts connected by a helix. The segments were approximated by stripping the appliance at the midline in a V-shaped manner and the force exerted by the extraoral elastics. The procedure resulted in 8 weeks, which may be regarded as a reasonable duration. The anterior cleft gap, which was 13 mm before the treatment, was reduced to 3 mm after the treatment by using modified PAM appliance. On the 21 months follow-up, oral reshaping was regarded successful due to stability of the improved oral mold.

Keywords: Appliances, Cleft lip and palate, Craniofacial anomalies, Functional

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Korean J Orthod

Published online July 22, 2021

Copyright © The Korean Association of Orthodontists.

Presurgical Alveolar Molding Treatment of an Infant with Down Syndrome and Tessier No. 0 Cleft: 21 Months' Follow-up

Gonca Mervea, Ozel Mehmet Birolb

aDepartment of Orthodontics, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
bDepartment of Orthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey Corresponding author: Dr. Gonca Merve, Assistant Professor, Department of Orthodontics, Recep Tayyip Erdogan University Faculty of Dentistry, Rize, Turkey

Correspondence to:Merve Gonca
Recep Tayyip Erdogan University, Rize, Turkey
Department of Orthodontics, Faculty of Dentistry
Assistant Professor DDS
Phone: +90 464 222 0000
Fax: +90 464 222 00 02
Email: mervegonca@gmail.com
Mehmet Birol ÖZEL
Kocaeli University, Kocaeli, Turkey
Department of Orthodontics, Faculty of Dentistry
Assistant Professor Ph.D, DDS
Tel: +90 262 344 22 22 – 5168
Fax: +90 262 344 21 09
Email: birolozel@hotmail.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Craniofacial clefts are extremely rare deformities. Tessier’s classification is a widely accepted method that is based on clinical, radiologic, and surgical observations. The Tessier No. 0 cleft most commonly affects the upper lip, the nose, and the palate. The purpose of this case presentation was to report the effects of a modified presurgical alveolar molding (PAM) appliance applied to an infant with Tessier No. 0 cleft and provide an alternative approach for shaping these defects. The modified PAM appliance consisted of reciprocal parts connected by a helix. The segments were approximated by stripping the appliance at the midline in a V-shaped manner and the force exerted by the extraoral elastics. The procedure resulted in 8 weeks, which may be regarded as a reasonable duration. The anterior cleft gap, which was 13 mm before the treatment, was reduced to 3 mm after the treatment by using modified PAM appliance. On the 21 months follow-up, oral reshaping was regarded successful due to stability of the improved oral mold.

Keywords: Appliances, Cleft lip and palate, Craniofacial anomalies, Functional