OrthoAligner “NAM”: A Case Series of Presurgical Infant Orthopedics (PSIO) Using Clear Aligners

Abstract

Presurgical infant orthopedics (PSIO) is done to reduce the size of the cleft defect along with improving the arch alignment and nasolabial aesthetics in patients with cleft lip and palate, leading to an improvement of nasolabial aesthetics allowing for a tidier and more aesthetic reparative procedure and postsurgical scar. Since the 2000s, clear aligners have slowly and steadily treaded their way as an acceptable orthodontic modality, with their usage and acceptability increasing considerably over the past decade. Thus, from the knowledge gathered in its 10 years working with 3-dimensional (3-D) diagnosis, treatment planning, and 3-D Printing services, Compass 3D (Belo Horizonte, Brazil) developed the OrthoAligner NAM system. This case series highlights one of the world’s first documented cases of PSIO treated with a series of clear aligners.

Concepts and Clinical Applications of Intraoral 3D Scanning in the Management of Patients with Orofacial Clefts

“…The scanning process is usually done using a small-sized scanning tip, the newborn/infant's head is advised to be stabilized gently with the parent's hand while keeping the infant seated in the parent's lap. The overall intraoral scanning process should take less than 3 minutes, an exact reported average of 1 minute 30 seconds up to 2 minutes has been reported in literature [48].…”

“…However, it was not that popular for pediatric patients in craniofacial orthopedics and orthodontics, this was related to the possible discomfort, allergy, and respiratory obstruction from impression material in newborns with cleft palate [47]. The introduction of a digital workflow that includes IOS instead of conventional impression techniques then designing and 3D printing of clear aligner for nasoalveolar molding has paved the way to a more friendly yet accurate method of reducing the cleft defect before surgery [48]. The scanning process is usually done using a small-sized scanning tip, the newborn/infant's head is advised to be stabilized gently with the parent's hand while keeping the infant seated in the parent's lap.…”

Presurgical Infant Orthopaedics - Journey So Far

“…Recently NAM appliance has been modified by different authors in many ways. It includes modified muscle-activated maxillary orthopaedic appliance [45], incorporation of expansion screw [46], dynamic presurgical nasal remodeling intraoral appliance design [47], extra-oral nasal molding appliance [48], self-retentive appliance with orthodontic wire [49,50], use of TMA wire instead of SS wire for making nasal stent [51] and the latest technique of OrthoAligner "NAM" [52] & NAM custom aligners [53].…”

Current Applications of Artificial Intelligence in Cleft Care: A Scoping Review

“…Recent literature describes the use of digital technologies, such as using digital nasoalveolar molding (NAM) therapy (which consists of a series of plates used to reduce the severity of the nasolabial defect) will allow standard care while lowering the rate of infection, the need for specialist consultations, and the use of equipment ( 19 ). Case reports and series have described the usage of digital workflows, which can ease the burden of cleft on infants and their parents ( 20 , 21 ).…”