Nasoalveolar molding of bilateral cleft of the lip and palate infants with orthopaedic ring plate.

OBJECTIVE: To introduce a simple, self-retentive and cost effective presurgical infant orthopaedic plate with anterior ring to retract and align the grossly protruded and deviated pre-maxilla and to perform the nasoalveolar moulding in order to facilitate initial lip repair. METHOD: The study was conducted in the orthodontic department of dental section of CH & ICH Lahore. The nonprobable purposive sample consisted of 35 subjects (27 males, 8 females) with a median age of 7 days (1-13 days). Nonsyndromic patients with bilateral complete cleft lip and palate were included in the study, patients were treated with custom made orthopaedic plate with an acrylic ring around the protruded premaxilla for around 3 months. Anthropometric readings and cast impressions were used to calculate the pre and post treatment differences, the data was tabulated and analysed using SPSS v 12. RESULTS: The results showed highly significant (<.005) difference between the pre and post treatment records of variables except the intercanine distance where the results are significant, i.e., (< 0.05). CONCLUSION: The orthopaedic plate causes significant retraction of the premaxillary segment without applying extra oral forces. It produces columellar elongation and increase in prolabium length facilitating the primary cheiloplasty and rhinoplasty to be precise and without additional scarring

Premaxillay retraction in bilateral complete cleft lip and palate with custom made orthopaedic plate having anterior acrylic ring.

OBJECTIVE: To determine retraction and alignment of protruded and rotated premaxillary segment and to measure increase in columellar length by using modified orthopaedic plate with anterior acrylic ring in newborn babies with non syndromic bilateral cleft lip and palate. METHODS: Pre surgical infant orthopaedic treatment of ten non syndromic bilateral cleft lip and palate new born babies was done. Modified orthopaedic plate with anterior acrylic ring was used. This was adjusted every week by adding increments of 1 mm acrylic along the inner surface contacting labial surface of pre maxillary segment and trimming the same amount along the anterior margin of the plate. Pre and post treatment dental cast and a 1:1 photocopy of dental cast was obtained to analyze the retraction, angulations and arch form. Data was compiled and analyzed in SPSS 10. RESULTS: A significant pre maxillary retraction, correction of rotation as well as increase of columellar length was achieved. CONCLUSION: The appliance proved most successful being used immediately after birth, making use of plasticity of the neonate cartilage due to maternal estrogen levels. Moreover the appliance maintained arch form facilitated function and rendered initial lip repair easy and tension free.

Autotransplantation of transmigrated mandibular canine.

Transplantation is the transfer of tissue or an organ from one site to another in the same person or between different persons. A transplantation in which donor and recipient are the same individual has been termed as autogenous transplantation, autoplastic transplantation, or autotransplantation. The purpose of this report was to describe a patient undergoing auto transplantation of an impacted mandibular canine to its normal position in the dental arch and the 1 1/2-year follow-up, with no sign of active inflammatory resorption or a periapical lesion. In addition, there was no sign of replacement resorprion (ankylosis). The endodontic literature has shown that the prognosis of patients undergoing autotransplantation may be good under specific considerations. Therefore, the technique may be a treatment option for the replacement of missing teeth whereever applicable.

Cephalometric assessment of patients with adenoidal faces.

OBJECTIVE: To evaluate the dentofacial morphology of adenoidal faces via linear and angular measurements on lateral cephalometric tracings and compare the extent of changes with control group. METHODS: A cross sectional study was conducted from January to July 2007 at the Department of Orthodontics, de'Montmorency Institute of Dental Sciences/Punjab Dental Hospital, Lahore (tertiary health center). As a non probability purposive sampling, total of 90 cephalometric radiographs of subjects (12 to 17 years of age) 45 with adenoidal faces and 45 subjects having normal class I and orthognathic profile were collected and utilized in the study. Subject with cranio-facial anomalies and syndromes, history of previous orthodontic treatment or trauma to the head and neck region were excluded. The collected data was entered on SPSS version 10 and analyzed by using, Paired 't' test. RESULTS: Significant difference is seen among the readings showing a drastically vertical pattern of growth in dentofacial complex, except the palatal inclination angle. CONCLUSION: The findings suggest that the subjects with upper airway obstruction display excessive vertical dentofacial development, leading to a long face appearance. The condition needs to be prevented by early recognition and treatment of the causative factor.