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Effect of PNAM with Nasal Stent on Infant Nasal Symmetry Correction of Complete Unilateral CLP Pre-Labioplasty: Three-dimensional Anthropometric Analysis Alamsyah, Gian Nur; Damayanti, Lisda; Aminah, Helmi Siti; Kusumadewi, An-Nissa
Indonesian Journal of Prosthodontic Special Issue 2021
Publisher : Indonesia Prosthodontic Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.323 KB) | DOI: 10.46934/ijp.v2i0.108

Abstract

Introduction: Infants with complete cleft lip and palate (CLP) exhibit asymmetrical characteristic of nasal deformation. Pre-surgical treatment by making presurgical nasalveolar molding (PNAM) with a nasal stent aims to assist the sucking and swallowing function of infants with CLP as well as passively moving separated alveolar segments and correcting nasal deformities in order to obtain more functional and aesthetically satisfactory surgical results. Objective: This study aimed to analyze the effect of PNAM insertion with a nasal stent on the correction of nasal symmetry in infants with complete unilateral cleft lip and palate. Methods: This research is a quasi experimental with one-group pre-treatment and post-treatment design. Five unilateral complete CLP infants were subjected to anthropometric measurements of alar displacement, columella height, nostril width nostril height and nostril axis inclination to obtain anthropometric ratios on the cleft and non-cleft sides with three-dimensional surface scanning before (T1) and after (T2) insertion of PNAM with nasal stent. Results: Analysis of the students' t-test showed a significant (p-value 0.05) between T1 and T2 in four anthropometric-ratio. Insertion of PNAM with nasal stent has resulted symmetrical nasal morphology of infants with complete unilateral CLP pre labioplasty with an increased ratio of columella height, nostril width, nostril height and nostril axis inclination between the cleft and non-cleft sides. Conclusion: Installation of PNAM with nasal stent can correct pre-labioplasty nasal symmetry.
Presurgical nasoalveolar molding modifikasi Hotz-Kogo dengan single nasal stent untuk perawatan pra-bedah bayi celah bibir dan langit-langit unilateral komplitHotz-Kogo modified presurgical nasalveolar molding with single nasal stent for pre-surgical treatment of complete unilateral cleft lip and palate infant Gian Nur Alamsyah; Lisda Damayanti; Taufik Sumarsongko
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 33, No 3 (2022): Maret 2022 (Suplemen 3)
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v33i3.30906

Abstract

ABSTRAK Pendahuluan: Defek kongenital pada daerah kraniofasial yang sering terjadi adalah celah bibir dan langit-langit (CBL). Bayi dengan CBL unilateral memiliki ciri khas pada sisi bercelah, premaksila akan berotasi dan terproyeksi ke luar, filtrum dan columella akan memendek pada satu sisi, dan miring ke arah sisi tidak bercelah. Segmen minor maksila akan mengalami hipoplastik dan retroposisi. Presurgical nasoalveolar molding (PNAM) merupakan plat ortopedik yang dapat mereposisi secara pasif segmen alveolar dan kartilago nasal sebelum labioplasty. Desain PNAM dengan modifikasi desain Hotz-Kogo yaitu perpaduan dari plat Hotz yang menutupi segmen alveolar kemudian memanjang ke posterior hingga uvula dipadukan desain plat Kogo dengan peninggian 2 mm di posterior plat yang berperan sebagai close box akan menambah retensi pada plat. Nasal stent memiliki kelebihan mengoreksi kartilago hidung yang immature dan mempertahankan pada posisi yang normal. Tujuan laporan kasus untuk menjelaskan tahapan dan hasil perawatan bayi pra bedah dengan PNAM desain modifikasi Hotz-Kogo dengan single nasal stent bayi celah bibir dan langit-langit unilateral komplit sinistra. Laporan kasus: Diagnosis laporan kasus ini labiognatopalatoschizis unilateral complete sinistra dirawat dengan menggunakan PNAM desain modifikasi Hotz-Kogo dan strapping ekstraoral. Nasal stent kemudian dipasang untuk membentuk kartilago nasal. Posisi premaksila dikoreksi dengan melakukan penyesuaian berkala pada permukaan anatomi PNAM. Hasil perawatan didapat posisi premaksila lebih baik dan celah menyempit, serta morfologi nasal yang lebih simetris antara sisi bercelah dan tidak bercelah. Simpulan: Penanganan pra bedah dengan pembuatan PNAM modifikasi Hotz-Kogo dengan single nasal stent pada bayi CBL unilateral komplit, dapat mengkoreksi posisi premaksila dan memperkecil jarak celah sebelum tindakan labioplasty. Kata kunci: presurgical nasoalveolar molding; nasal stent; celah bibir dan langit-langit. ABSTRACTIntroduction: Congenital defects in the craniofacial area, amongst others, are cleft lip and palate (CLP). Infants with unilateral CLP have a characteristic on the cleft side. The premaxilla will rotate and project outward; the philtrum and columella will shorten on one side and tilt toward the non-cleft side. The minor maxillary segment is hypoplastic and retroposition. Presurgical nasalveolar moulding (PNAM) is an orthopaedic plate that can passively reposition the alveolar and nasal cartilage segments before labioplasty. The PNAM with a modified Hotz-Kogo design combines the Hotz plate that covers the alveolar segment and extends posteriorly to the uvula combined with the Kogo plate design with a 2 mm elevation on the posterior plate, which acts as a close box will increase the retention of the plate. Nasal stents can correct the immature nasal cartilage and maintain it in its normal position. This case report presented the stages and outcomes of presurgical treatment with Hotz-Kogo modified PNAM design with a single nasal stent for infants with unilateral complete left cleft lip and palate. Case report: Diagnosis in this case report was unilateral complete left labiognatopalatoschizis, treated with Hotz-Kogo modified design PNAM and extraoral strapping. A nasal stent was then placed to form the nasal cartilage. The premaxillary position was corrected by making periodic adjustments to the anatomic surface of the PNAM. The treatment results obtained a better premaxillary position, narrowed slits, and a more symmetrical nasal morphology between cleft and non-slit sides. Conclusion: Presurgical treatment with Hotz-Kogo modified PNAM with a single nasal stent in complete unilateral CBL infants can correct the premaxillary position and reduce the gap before labioplasty.Keywords: presurgical nasoalveolar moulding; nasal stent; cleft lip and palate.
Management of Unilateral Cleft Lip and Palate using Presurgical Nasoalveolar-Molding Meidarlina, Ista; Alamsyah, Gian Nur
B-Dent: Jurnal Kedokteran Gigi Universitas Baiturrahmah Vol 12, No 1 (2025): Vol 12 No 1 (Juni 2025)
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/jbd.v12i1.1738

Abstract

Cleft lip and palate (CLP) is a common congenital defect in craniofacial. The patient with  CLP experiences difficulty in breastfeeding which can affect their nutritional status. The presurgical nasoalveolar molding (PNAM) is a device used to overcome this problem. This case report aims to describe the pre-surgical treatment using PNAM with a Hotz-Kogo modification design.  This case report presented a two-week-old infant who had unilateral CLP. The alar base widened, the pro-labium and columella were shortened on one side and tilted towards the non-cleft side, and the minor segment of the maxilla was hypoplastic and retroposition. This patient experienced difficulty in breastfeeding and will be treated with PNAM with ekstra oral strapping and nasal stent. The PNAM was adjusted regularly. After using PNAM, the patient had a good sucking reflex and was easy to breastfeed, the position of the premaxilla was corrected, and the nasal morphology was more symmetrical before labioplasty. The presurgical PNAM is a device that functions as a feeding aid to help the baby get good nutrition and also as a pre-surgical treatment to reduce the severity of oronasal deformity before surgery.
Comparison of the retentive ability on incisal bite force between aloe vera and poly(methyl-vinyl-ether) adhesive materials in complete acrylic denture measured by modified pressure transducer Julinda, Marisa; Sumarsongko, Taufik; Alamsyah, Gian Nur; Adenan, Aprillia
Padjadjaran Journal of Dentistry Vol 33, No 1 (2021): March 2021
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjd.vol33no1.23907

Abstract

Introduction: Patients with acrylic complete denture, usually have a confidence issue in using their complete dentures to chew and speak, because of concern about detached of the denture from its place and pain on the alveolar ridge. Application denture adhesive material ordinarily can solve the problem. Mostly, denture adhesives in the market are made from synthetic material poly(methyl-vinyl-ether) but nowadays aloe vera extract is believed to be a substitute to synthetic denture adhesive material. The purpose of this study was to analyzed of comparison the retentive ability on incisal bite forces between aloe vera extract and poly(methyl-vinyl-ether) adhesive in complete acrylic denture ameasured by modified pressure tranducer. Methods: This true-experimental research used 10 samples from patients who used acrylic complete denture and meet suitable criteria. Samples were tested in three different interventions, the first one applied by denture adhesive made from poly(methyl-vinyl-ether), the second one applied by denture adhesive made from aloe vera extract and the third one as a control group, sample was tested without any application of denture adhesive. Retentive ability on incisal bite forces was measured by modified pressure transducer with integrated software. Data was analysis using ANOVA method. Results: Anterior bite force as control 20,98 N, aloe vera 23,42 N, poly (methyl-vinyl-ether) 21,25 N and without denture adhesive as control. Significant differences in the incisal bite force dislodgement of dentures that were applied with Aloe vera-based denture adhesive s with p-value of 0.0088. Conclusion: Denture adhesive made from Aloe vera extract had the highest adhesiveness incisal bite force value compared to denture adhesive made from poly(methyl-vinyl-ether) and without denture adhesive.