INTRODUCTION: Cleft lip and palate (CLP) affects about 1.5 per 1000 live births (250,000 new cases per year) worldwide. They can be either unilateral or bilateral, complete or incomplete. The bilateral cleft lip and palate (BCLP) deformity typically arises with a protrusive premaxilla. The nasal deformity includes deficient columella, with flared lateral alar cartilages which usually require additional surgeries to improve the nasal symmetry. NasoAlveolar Moulding (NAM) technique, aims to align the alveolus, lip, and nose properly; reduce the severity of the nasal deformity, and lengthen the columella without surgery. OBJECTIVES: The study aims to quantify the effect of NAM therapy, fabricated by CAD/CAM additive manufacturing, in the improvement of nasolabial deformity in terms of bialar width, columellar length and width in infants with complete BCLP. MATERIALS AND METHODS: Ten infants with non-syndromic BCLP (age < 1 month) were selected. Impressions were obtained. The casts obtained from the impressions were scanned using a 3D laser scanner. Designing and 3D printing of the appliances were completed. The appliances were inserted and retained using surgical tapes. Nasal stents were incorporated 60 days after the start of the treatment. Nasal measurements were obtained before treatment and at the end of treatment (after four months). RESULTS: Data was collected and statistically analyzed. After NAM therapy, there was a statistically significant increase in columellar length and a statistically significant decrease in both columellar width and bialar width. CONCLUSIONS: CAD/CAM PNAM therapy has proved its effectiveness in BCLP by showing an improvement in the columellar and bialar presurgical presentation. CAD/CAM PNAM therapy should be considered a routine procedure in the treatment protocol for BCLP.
INTRODUCTION: Investigators have been searching for ideal maxillofacial prosthetic materials in order to gain patient acceptance and can be fabricated easily in the dental setting. OBJECTIVES: To evaluate the influence of adding different concentrations of titanium oxide nanoparticles (TiO2 NPs) on the mechanical properties of facial silicone elastomer (SE) after different extra-oral aging methods. MATERIALS AND METHODS: TiO2 nanoparticles were mixed with MED-4210 maxillofacial silicone elastomer at 1.5 %, 2% and 2.5 % weight percentage (w/w). Unmodified silicone was served as control group. Each of the above groups were evaluated to mechanical properties before aging conditions. Control & 2.5% nano-TiO2 silicone elastomers groups were subjected to six equal aging conditions groups as follow. Dry storage in dark for 6 months, storage in simulated sebum solution for 6 months, storage in simulated acidic perspiration for 6 months, accelerated artificial daylight weathering for 360 hours, storage in antimicrobial silicone-cleaning solution for 30 hours and mixed aging of sebum under UV light for 360 hours. After aging exposures, they were evaluated to the mechanical properties. Data were analyzed using the Kolmogorov-Smirnov test, F-test (ANOVA) and Post-hoc pair-wise test. RESULTS: TiO2 nanoparticles addition improved the mechanical properties in terms of tensile strength and percentage elongation, tear strength and shore A hardness of MED-4210 maxillofacial silicon elastomer before and after extra-oral aging conditions (P < 0.05). Pair-wise comparison between control group and 2.5% nano-TiO2 silicone elastomers composite exhibited significant differences according to the mechanical properties after aging. CONCLUSIONS: Reinforcement of MED-4210 maxillofacial silicon elastomer with TiO2 nanoparticles introduces a favorable material with physical and anti-ageing properties in our in vitro study.
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