RESUMO
Objective: Presurgical nasoalveolar molding (PNAM) using a modified nostril retainer is a new treatment approach. This study aimed to evaluate the outcomes of early nasal molding using this approach with an average follow-up of 2 years in patients with severe unilateral cleft lip and palate. Methods: This retrospective study included 18 patients with unilateral cleft lip and palate without genetic syndromes who underwent PNAM with modified nostril retainers. The Grayson technique was employed with an intraoral plate to approximate cleft segments. Nasal molding was initiated before reducing the cleft width to 5 mm. Measurements, including alar base height ratio (ABHR), nasal floor width ratio (NFWR), columellar length ratio (CLR), columellar angle (CA), and nostril axis inclination on the cleft and non-cleft sides (NAI-C and NAI-NC, respectively), were calculated from standard photographs taken before PNAM (T1), after PNAM (T2), after an average of 1.81 months post-surgery (T3), and after an average of 2.2 years after T3 (T4). Pairwise comparisons of values at the four time points were conducted. Results: NFWR, CLR, CA, NAI-C and NAI-NC significantly increased after PNAM (p<0.05). However, no significant change was observed in ABHR (p>0.05) from T1 to T2. These outcomes were maintained at T4, and no patient developed a mega nostril. Conclusion: The use of a modified nostril retainer for nasal molding appears to provide stability during the high probability of relapse reported in the literature.
RESUMO
The purpose of this study was to evaluate the morphological structure of palatal rugae in Turkish orthodontic subjects with different sagittal skeletal malocclusions. Orthodontic dental casts of 105 patients (Class I [23 females, 12 males]; 35, Class II [18 females, 17 males]; and 35, Class III [14 females, 21 males] 10-22 years old) were analyzed for rugae patterns. Palatal rugae pattern and number, direction of rugae alignment, shape of incisive papilla were analyzed. Modified Thomas and Kotze classification was performed to analyze palatal rugae characteristics. The data were analyzed using the Kruskal-Wallis test. Wavy and curved types were the most common types of rugae pattern in all groups (Class I, Class II, Class III). As regards to the number of primary and secondary rugae on the left and right sides, there was no statistically significant difference among subjects with different skeletal malocclusions. Droplet-shaped incisive papilla was the most common form of incisive papillae among different skeletal malocclusion groups. The most common palatal rugae were direction type arranged in the horizontal direction. All rugae patterns were unique for each individual. The use of antemortem or postmortem palatal rugae records may facilitate identification of the suspects in forensic investigations by enabling facial reconstruction through skeletal malocclusions.
