A modified presurgical alveolar molding technique for treatment of cleft in Down syndrome


KOREAN JOURNAL OF ORTHODONTICS, vol.51, no.6, pp.428-434, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 51 Issue: 6
  • Publication Date: 2021
  • Doi Number: 10.4041/kjod.2021.51.6.428
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.428-434
  • Keywords: Appliances, Cleft lip and palate, Craniofacial anomalies, Functional, LIP, PALATE, INFANTS, CHILDREN
  • Kocaeli University Affiliated: Yes


Craniofacial clefts are extremely rare deformities. Tessier's classification is a widely accepted system that is based on clinical, radiographical, and surgical observations. The Tessier No. 0 cleft most commonly affects the upper lip, nose, and palate. This case presentation aims to report the outcome of a modified presurgical alveolar molding (PAM) appliance used in the treatment of an infant with Tessier No. 0 cleft as an alternate approach to mold such defects before surgery. The modified PAM appliance consisted of reciprocal parts connected by a helix. The segments were approximated by stripping the appliance at the midline in a V-shaped manner and the force was exerted by the extraoral elastics. The procedure gave results in 8 weeks, which may be regarded as a reasonable duration. The anterior cleft gap, which was 13 mm before the treatment, was reduced to 3 mm after the treatment by using modified PAM appliance. On a 21- month follow-up period, oral reshaping was regarded successful due to stability of the improved oral mold.