Effects of Nasoalveolar Molding Therapy on Alveolar and Palatal Cleft Deformities in Unilateral and Bilateral Cleft Lip and Palate.

OBJECTIVE: The purpose of this study was to evaluate and compare the efficacy of nasoalveolar molding (NAM) therapy in the improvement of alveolar and palatal cleft deformity on unilateral (UCLP) versus bilateral (BCLP) cleft lip and palate. MATERIALS AND METHODS: A total of 19 UCLP (14 boys and 5 girls) and 8 BCLP (7 boys and 1 girl) infants completed NAM therapy were included in this study. Standardized parameters of cleft width of alveol and palate were measured on photocopies taken from the pre- and post-treatment plaster casts. To assess the intragroup differences, paired-samples test in UCLP and Wilcoxon test in BCLP groups were used. Mann-Whitney U test was used to evaluate the differences between the groups. RESULTS: Significant decreases in alveolar and palatal cleft gaps were achieved in an average period of 3.3 ±â€Š1.9 and 3.7 ±â€Š1.6 months in UCLP and BCLP patients, respectively. The alveolar cleft decreased 7.85 ±â€Š4.59 mm in UCLP and 4.25 ±â€Š3.13 and 3.81 ±â€Š3.50 mm in right and left alveolar cleft sides in BCLP, respectively. The palatal clefts were decreased 4.63 ±â€Š2.44 mm in medial and 3.72 ±â€Š2.62 mm in posterior parts in UCLP. The decrements in BCLP were 3.00 ±â€Š2.75 mm in medial and 2.88 ±â€Š2.75 mm in posterior palatal cleft distances. No significant differences were determined in the amount of alveolar or palatal cleft closure between UCLP and BCLP groups. The only decrease in arch width was 1.39 mm in medial part of palate in UCLP. CONCLUSION: The NAM device provides significant decreases in both alveolar and palatal cleft deformities in UCLP and BCLP infants, as compared with their birth status.

Effects of thermoplastic retainers on occlusal contacts.

The aim of this prospective study was to evaluate the number of contacts in centric occlusion during retention with thermoplastic retainers (Essix retainers) and in the long term. After four premolar extractions and active orthodontic treatment of 15 Class I (10 females, 5 males; mean age 17.20 +/- 1.7 years), thermoplastic retainers were used. Occlusal contacts were determined from occlusal registrations taken in centric occlusion at the beginning (T0), end (9 months of retention; T1), and after 2.5 years (T2). The occlusal contacts determined in these patients were compared with the values of 15 'normal' Class I subjects (9 females, 6 males; mean age 17.10 +/- 1.60 years) who had not undergone orthodontic treatment. Wilcoxon and a Mann-Whitney U-tests were used to evaluate intra- and intergroup differences. No significant change was observed in the number of posterior contacts during T1, whereas a significant increase was found at T2 (P < 0.01) for the second premolars (P < 0.01) and second molars (P < 0.05). Both 'ideal' and 'non-ideal' contacts increased significantly but only at T2 (P < 0.05). The number of ideally located contacts on the posterior teeth at all three periods were lower than normal values (P < 0.01); while non-ideal contacts at T1 (P < 0.05) and T2 (P < 0.01) were found more often when compared with the values of normal subjects. Only the increased number of premolar contacts at T2 was more than normal values (P < 0.01). There was no expected increase in occlusal contacts at T2; however, posterior occlusal contacts were increased at T3.