title: Effective retropulsion and centralization of the severely malpositioned premaxilla in patients with bilateral cleft lip and palate: a novel modified presurgical nasoalveolar molding device with retraction screw.
abstract: OBJECTIVE
  A novel, modified presurgical nasoalveolar molding (MPNAM) device with retraction screw was designed and used in patients with bilateral complete cleft lip and palate (BCCLP) to rapidly retract and centralize the protuberant and malpositioned premaxilla and correct the nasolabial and palatal deformities. The orthopedic effects and possible complications were evaluated.
  
  
  METHODS
  Nine patients with BCCLP who met the inclusion criteria were selected. After the maxillary model was obtained, the new MPNAM device with retraction screw was designed and worn until cheilorrhaphy. Changes in local deformities and complications were observed continuously, and the orthopedic effect was evaluated.
  
  
  RESULTS
  All patients quickly adapted to the MPNAM appliance, and the treatment was finished after 5-8 return visits. The columella was significantly prolonged, the nasal tip was elevated, and the collapsed nasal dome was obviously improved. Simultaneously, the premaxilla was rapidly retracted and rotated, and gradually centralized; the clefts were gradually reduced and closed, and a nearly normal dental arch was formed. Although there were some complications, the orthopedic treatment was continued until cheiloplasty.
  
  
  CONCLUSIONS
  The MPNAM device with retraction screw can simultaneously correct nasolabial and palatal deformities and also rapidly retract and centralize the premaxilla.
authors.affiliation: Oral Department (Associate Prof, Dr.), Children's Hospital, Chongqing Medical University, 136 Zhongshan er Road, Yuzhong District, Chongqing, 400014, PR China. Electronic address: cqlwsam2622@163.com.
authors.forename: Wanshan
authors.initials: W
authors.lastname: Li
authors.affiliation: Oral Department, Children's Hospital, Chongqing Medical University, Chongqing, 400014, PR China.
authors.forename: Lishu
authors.initials: L
authors.lastname: Liao
authors.affiliation: Moco Dental Clinic, Chongqing, 401120, PR China.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Dai
authors.affiliation: Oral Department, Children's Hospital, Chongqing Medical University, Chongqing, 400014, PR China.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Oral Department, Children's Hospital, Chongqing Medical University, Chongqing, 400014, PR China.
authors.forename: Leixi
authors.initials: L
authors.lastname: Ren
authors.affiliation: Oral Department, Children's Hospital, Chongqing Medical University, Chongqing, 400014, PR China.
authors.forename: Yutao
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000180:Acrylic Resins / Q000737:chemistry; D001672:Biocompatible Materials / Q000737:chemistry; D002971:Cleft Lip / Q000601:surgery / Q000628:therapy*; D002972:Cleft Palate / Q000601:surgery / Q000628:therapy*; D003724:Dental Arch / Q000473:pathology; D004867:Equipment Design; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008437:Maxilla / Q000473:pathology*; D009666:Nose / Q000473:pathology; D009989:Orthotic Devices; D010159:Palate / Q000473:pathology; D012399:Rotation; D013193:Stainless Steel / Q000737:chemistry; D015607:Stents
chemical_list: D000180:Acrylic Resins; D001672:Biocompatible Materials; D013193:Stainless Steel
keywords: Bilateral complete cleft lip and palate; Premaxilla; Presurgical nasioalveolar molding devices; Retraction screw