Four-year follow-up comparison of three pre-surgical infant orthopedic methods on mandibular arch morphology in unilateral cleft lip and palate: A retrospective study

IF 1.8 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International Orthodontics Pub Date : 2025-05-02 DOI:10.1016/j.ortho.2025.101013

Puneet Batra , Ajay Kubavat , Dhruv Ahuja

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Abstract

Objective

To evaluate the impact of presurgical infant orthopedics (PSIO) on mandibular dimensions and inter arch relation at 4 years follow-up comparing three different PSIO methods (modified Grayson's technique, Dynacleft nasal elevator, OrthoAligner NAM with Dynacleft nasal elevator) to no-nasoalveolar molding (NAM) in infants with unilateral cleft lip and palate (UCLP).

Methodology

A retrospective cohort study was conducted on non-syndromic UCLP patients treated with either PSIO or no-PSIO between 2018 and 2019, with a 4-year follow-up. The cohort was divided into four groups of 13 patients each: group 1 received PSIO with the modified Grayson's technique, group 2 received PSIO with the Dynacleft nasal elevator, group 3 was treated with OrthoAligner NAM combined with Dynacleft nasal elevator, and group 4 received no PSIO. Mandibular transverse width and interarch relation were assessed using the Modified Huddart and Bodenham (MBH) index. Descriptive statistics, ANOVA, and the Chi-square test were used to compare mandibular dimensions and interarch relationships across the groups.

Results

A total of 52 patients (29 boys, 23 girls) were included in the study. Mandibular arch dimensions showed no significant differences across groups (P > 0.05), with inter-canine (Grayson: 26.31 mm, Dynacleft: 27.42 mm, OrthoAligner: 28.27 mm, no-NAM: 27.15 mm), anterior arch (33.36–33.50 mm), inter-molar (36.50–36.77 mm), and posterior arch widths (42.36–42.61 mm). Crossbite and interarch occlusal relationships showed comparable distribution among all groups, with no significant variations (P > 0.05).

Conclusion

The study found no significant differences in mandibular transverse arch dimensions or inter arch occlusal relationships among different PSIO modalities, indicating that the choice of PSIO modality did not substantially impact arch width or occlusion interarch relation.

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三种术前矫形方法对单侧唇腭裂婴幼儿下颌弓形态的影响：回顾性研究

目的比较改良Grayson技术、Dynacleft鼻提升器、矫形器NAM联合Dynacleft鼻提升器三种不同的婴儿术前矫形术（PSIO）对单侧唇腭裂（UCLP）婴儿无鼻牙槽成型（NAM） 4年随访对下颌尺寸和弓间关系的影响。方法回顾性队列研究于2018 - 2019年对接受PSIO或不接受PSIO治疗的非综合征性UCLP患者进行4年随访。将队列分为4组，每组13例患者，组1采用改良Grayson技术进行PSIO，组2采用Dynacleft鼻提升器进行PSIO，组3采用OrthoAligner NAM联合Dynacleft鼻提升器进行PSIO治疗，组4不进行PSIO治疗。采用改良的Huddart and Bodenham （MBH）指数评估下颌横向宽度和弓间关系。使用描述性统计、方差分析和卡方检验比较各组下颌尺寸和弓间关系。结果共纳入52例患者，其中男29例，女23例。下颌弓尺寸各组间差异无统计学意义(P >；0.05)，犬齿间（Grayson: 26.31 mm, Dynacleft: 27.42 mm, OrthoAligner: 28.27 mm, no-NAM: 27.15 mm），前弓（33.36-33.50 mm），磨牙间（36.50-36.77 mm）和后弓宽度（42.36-42.61 mm）。各组间牙合关系和牙间咬合关系的分布具有可比性，无显著差异(P >；0.05)。结论不同PSIO方式的下颌横弓尺寸及弓间咬合关系无显著差异，说明PSIO方式的选择对弓宽及牙合关系无显著影响。

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来源期刊

International Orthodontics DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

2.50

自引率

13.30%

发文量

审稿时长

26 days

期刊介绍： Une revue de référence dans le domaine de orthodontie et des disciplines frontières Your reference in dentofacial orthopedics International Orthodontics adresse aux orthodontistes, aux dentistes, aux stomatologistes, aux chirurgiens maxillo-faciaux et aux plasticiens de la face, ainsi quà leurs assistant(e)s. International Orthodontics is addressed to orthodontists, dentists, stomatologists, maxillofacial surgeons and facial plastic surgeons, as well as their assistants.