title: Thermoplastic resin used to modify an alveolar orthopedic prosthesis in a patient with cleft lip before cheiloplasty: a clinical report.
abstract: Correction of cleft lip and cleft palate is a multidisciplinary team effort. Severe bilateral clefts with protruded and rotated premaxillae may complicate surgical correction. Prosthetic intervention to reposition segments before surgical correction may improve the bony base for tissue molding and avoid excess tension at the surgical site. A conventional bulb prosthesis with bonnet and straps is often used as an extraoral device to retract a protruded premaxilla for severe cleft patients before cheiloplasty. Sometimes, because of lack of retention, stability, patient compliance, and controllable forces from a bonnet and straps, movement of the premaxillae to a desirable position is difficult to achieve. The use of thermoplastic resin to modify a bulb prosthesis as described in this clinical report is a simple method to provide good retention for the bulb prosthesis and to move a laterally displaced premaxillae to the facial midline. The wedging effect created by the thermoplastic resin generated "compressive forces" to the premaxilla that was more controllable than the pulling forces created by the bonnet and straps therapy. Thermoplastic resin is also a better material than a conventional chemically polymerized acrylic resin in dealing with an infant's delicate mucosa before cheiloplasty.
authors.affiliation: Department of Restorative Dentistry, School of Dentistry, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Wang
mesh_terms: D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D006801:Humans; D007223:Infant; D016382:Orthodontic Appliance Design; D010158:Palatal Obturators; D012117:Resins, Synthetic
chemical_list: D012117:Resins, Synthetic