Alinhadores NAM com elevador nasal: um estudo clínico em pacientes com fissura labiopalatal
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Data
2021-11-08
Autores
Frazão, Diogo Campos
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Universidade Estadual Paulista (Unesp)
Resumo
A fissura de lábio e palato é a deformidade congênita da face mais comum em humanos e acomete cerca de 1:650 nascimentos no Brasil. O tratamento para esses pacientes tem sido amplamente discutido durante décadas e ainda não existe um consenso ou um protocolo de atendimento padronizado. Com o passar dos anos e a evolução da tecnologia, novas formas de tratamento foram surgindo e hoje é possível realizarmos o tratamento desses pacientes através do planejamento digital (CAD/CAM – Projeto e fabricação assistida por computador). A partir do conceito dos alinhadores ortodônticos introduzido por Kesling em 1946 e hoje com toda tecnologia disponível para fabricação digital desses dispositivos é que realizamos o tratamento de 25 bebês fissurados no projeto de extensão denominado NAM – Naso-Alveolar Modelador do Departamento de Odontologia Restauradora na Faculdade de Odontologia da Universidade Federal de Minas Gerais, avaliando a eficácia da utilização dos alinhadores NAM no fechamento das fissuras do rebordo alveolar. O tratamento com os alinhadores NAM se mostrou eficiente com a diminuição de pouco mais de 50% do tamanho da fenda anterior e com os pacientes realizando o tratamento à distância reduzindo o número de consultas presenciais. A tecnologia CAD/CAM com os alinhadores NAM tornará acessível a pacientes que residem longe dos centros de deformidades, particularmente em áreas rurais, além da possibilidade de padronização do tratamento no mundo global. Embora ainda em estágios iniciais, os alinhadores NAM representam um tratamento promissor para pacientes portadores de fissuras lábio palatinas.
Cleft lip and palate is the most common facial deformity in humans, afflicting 1:650 births in Brazil. Optimal treatment protocols have been debated over the last several years but no consensus has yet been reached. Recently several technological advancements have made possible to develop new ways to treat cleft lip and palate patients using 3D treatment planning softwares to produce customized appliances for pre-surgical orthopaedic treatment of newborns. This new technique is based on well established Clear Aligners introduced by Kesling in 1946. The current manuscript aims to evaluate the outcomes of 25 babies (15 to 30 days-old) treated with clear aligners to reduce the cleft and the gap between the alveolar segments prior to lip and palate repair surgery. Treatment with NAM aligners proved to be efficient with a reduction of just over 50% in the size of the anterior cleft and with patients undergoing treatment at a distance, reducing the number of face-to-face consultations. CAD/CAM technology with NAM aligners will make it accessible to patients residing far from deformity centers, particularly in rural areas, in addition to the possibility of standardizing treatment in the global world. Although still in early stages, NAM aligners represent a promising treatment for patients with cleft lip and palate.
Cleft lip and palate is the most common facial deformity in humans, afflicting 1:650 births in Brazil. Optimal treatment protocols have been debated over the last several years but no consensus has yet been reached. Recently several technological advancements have made possible to develop new ways to treat cleft lip and palate patients using 3D treatment planning softwares to produce customized appliances for pre-surgical orthopaedic treatment of newborns. This new technique is based on well established Clear Aligners introduced by Kesling in 1946. The current manuscript aims to evaluate the outcomes of 25 babies (15 to 30 days-old) treated with clear aligners to reduce the cleft and the gap between the alveolar segments prior to lip and palate repair surgery. Treatment with NAM aligners proved to be efficient with a reduction of just over 50% in the size of the anterior cleft and with patients undergoing treatment at a distance, reducing the number of face-to-face consultations. CAD/CAM technology with NAM aligners will make it accessible to patients residing far from deformity centers, particularly in rural areas, in addition to the possibility of standardizing treatment in the global world. Although still in early stages, NAM aligners represent a promising treatment for patients with cleft lip and palate.
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Palavras-chave
Modelador Nasoalvolar, Fissura lábio e palato, CAD/CAM, Alinhadores, Nasoalveolar molding, Clef lip and palate, CAD/CAM, Aligners