Nasoalveolar Molding

鼻肺泡成型
  • 文章类型: Journal Article
    目的:对同行评审的医学文献中的数据进行系统回顾,并评估唇贴作为鼻-肺泡成型(NAM)术前技术在唇裂和/或腭裂婴儿中的有效性。
    方法:对各种相关研究的数据库进行电子搜索,不管日期,从成立到2023年6月进行了评估。在完成电子搜索并应用我们的纳入/排除标准后,6项研究-2项随机对照试验,2项非随机研究,包括2个病例系列。相关文章的数据提取由2位作者独立完成。使用JBI患病率关键评估工具进行质量评估,并通过GRADE方法进行证据的确定性。
    方法:鼻唇美学,牙槽骨的关系。
    结果:本综述共纳入6项研究。进行了Meta分析,和森林地块是从唇带组获得的单一平均值。3项研究的偏倚风险较低,而3项研究显示存在严重的偏倚风险。与对照组相比,尽管证据的确定性很低,但唇膏在各种结果指标上显着改善。
    结论:与无治疗相比,唇贴似乎改善牙槽的测量和鼻唇的美学。为了增加我们对唇膏的了解,未来需要更多的研究,因为没有多少研究证明唇贴比其他治疗方法更好。
    OBJECTIVE: To conduct a systematic review of the data in peer-reviewed medical literature and evaluate the effectiveness of lip taping as a pre-surgical naso-alveolar molding (NAM) technique in infants with cleft lip and/or palate.
    METHODS: An electronic search of various databases for relevant studies, regardless of date, from inception to June 2023 was carried out and evaluated. After completing the electronic search and applying our inclusion/exclusion criteria, 6 studies-2 randomized control trials, 2 non-randomized studies, and 2 case series-were included. Data extraction of relevant articles was done independently by 2 authors. Quality assessment was done using the JBI prevalence critical appraisal tool and certainty of evidence was carried out by GRADE approach.
    METHODS: Nasolabial Aesthetics, Dentoalveolar Relationship.
    RESULTS: A total of six studies were included in the current review. Meta-analysis was carried out, and forest plots were obtained for a single mean from the lip-taping group. 3 studies had a low risk of bias, while 3 studies displayed a serious risk of bias. Significant improvement in various outcome measures was noted with lip taping when compared with the control group although the certainty of evidence was very low.
    CONCLUSIONS: When compared to no therapy, lip taping appears to ameliorate dentoalveolar measurements and nasolabial aesthetics. To increase our knowledge of lip taping, more research will be needed in the future, as there are not many studies to prove lip taping is better than other treatment approaches.
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  • 文章类型: Journal Article
    目的:本研究旨在对数字化技术在新生儿/婴幼儿唇腭裂(CLCP)术前骨科中应用的优势和不足进行全面综述和个案研究。鼻腔解剖结构的积极变化,上颌弓,和裂缝宽度可以实现。
    方法:使用术前新生儿/婴儿骨科(PSIO)方法对3例具有代表性的CLCP新生儿/婴儿病例进行管理。对患者进行了诊断和治疗。为每种情况提供了印模程序和PSIO器具构造和放置的详细描述。
    结果:案例1利用了传统的印模技术,案例2采用半数字化方法进行口内数字扫描,案例3采用了完全数字化的设备施工方法。在所有病例中均观察到上颌弓尺寸和裂隙宽度减小的积极变化。
    结论:新生儿和婴儿CLCP的管理提出了一个具有深远意义的复杂挑战。PSIO方法不仅促进了重建手术,而且提高了整体生活质量。数字工具,比如专门的光学扫描仪和3D打印,彻底改变PSIO流程,使它更有效和病人友好。临床益处包括改善面部形态,美学,喂养,演讲,并优化了未来的手术效果。尽管正在进行功效辩论,全球采用作为最初的手术方法强调了其价值。数字技术的融合为患者和家庭带来了新的希望,为受这种先天性疾病影响的人承诺一个更光明的未来。
    OBJECTIVE: This study aims to provide a comprehensive review and case study about the advantages and disadvantages of the application of digital technologies in presurgical orthopedics in newborns/infants with cleft lip and palate (CLCP). Positive changes in the nasal anatomy, maxillary arch, and cleft width could be achieved.
    METHODS: Three representative cases of newborns/infants with CLCP were managed using the presurgical newborn/infant orthopedics (PSIO) approach. The patients were diagnosed and treated. Detailed descriptions of the impression procedures and PSIO appliance construction and placement were provided for each case.
    RESULTS: Case 1 utilized traditional impression techniques, Case 2 employed a semi-digitalized approach with intraoral digital scanning, and Case 3 utilized a completely digitalized method for appliance construction. Positive changes in maxillary arch dimensions and cleft width reduction were observed in all cases.
    CONCLUSIONS: The management of CLCP in newborns and infants poses a complex challenge with profound implications. The PSIO approach not only facilitates reconstructive surgery but also enhances overall quality of life. Digital tools, like specialized optical scanners and 3D printing, revolutionize the PSIO process, making it more efficient and patient-friendly. Clinical benefits include improved facial morphology, esthetics, feeding, speech, and optimized future surgical results. Despite ongoing efficacy debates, global adoption as the initial surgical approach underscores its value. The integration of digital technologies offers new hope for patients and families, promising a brighter future for those affected by this congenital condition.
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  • 文章类型: Journal Article
    本研究旨在通过进行系统评价和荟萃分析,分析鼻肺泡成型(NAM)作为裂隙初级治疗方案的一部分对非综合征性唇腭裂患者鼻唇沟美学的长期影响。截至2023年7月,共搜索了六个电子数据库和两个期刊。选择比较NAM和非NAM方案之间的鼻唇沟结果的研究进行进一步分析。鼻唇美学是感兴趣的结果。数据提取,方法学质量评估,偏见风险评估,进行meta分析和亚组分析。选择了7项回顾性队列研究进行定性审查,4项进行定量分析。在大多数研究中,偏倚评估的风险是中等的。仅纳入利用Asher-McDade评级(AMR)的研究进行荟萃分析。与其他协议相比,使用NAM的协议在vermillion边界上的AMR得分显着降低。NAM协议的鼻腔形式和鼻对称性的AMR得分显着低于没有任何手术前婴儿骨科(PSIO)的协议,但与其他PSIO技术的协议没有显着差异。NAM方案的鼻唇沟谱的AMR评分与其他方案没有显着差异。然而,亚组分析表明,NAM和原发性鼻成形术相结合的方案显着降低了鼻型的AMR评分,鼻对称和鼻唇沟轮廓。对于单侧唇裂伴或不伴腭裂(UCLP)的患者,这项研究发现,NAM和初次隆鼻手术相结合的方案可改善鼻唇沟结局,而单独使用NAM的方案仅提供有限的获益.对于BCLP患者,现有的证据仍然没有定论。联合进行NAM与原发性鼻成形术可改善UCLP患者的鼻唇美学。PROSPERO(CRD4202128384)。
    This study aims to analyze long-term effects of nasoalveolar molding (NAM) as a part of cleft primary management protocols on nasolabial aesthetics for patients with non-syndromic cleft lip and palate by conducting a systematic review and meta-analysis. Six electronic databases and two journals were searched up to July 2023. Studies comparing nasolabial outcomes between NAM and non-NAM protocols were selected for further analysis. Nasolabial aesthetics were the outcome of interest. Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis and subgroup analysis were performed. Seven retrospective cohort studies were selected for a qualitative review and four for a quantitative analysis. The risk of bias assessment was moderate for most studies. Only studies utilizing the Asher-McDade rating (AMR) were included for meta-analyses. The protocols with NAM exhibited a significantly lower AMR score for vermillion border than other protocols. AMR scores for nasal form and nasal symmetry from protocols with NAM were significantly lower than protocols without any pre-surgical infant orthopaedics (PSIO) but not significantly different from protocols with other PSIO techniques. The AMR score for nasolabial profile from protocols with NAM was not significantly different from other protocols. However, subgroup analysis demonstrated that protocol combining NAM and primary rhinoplasty significantly lowered AMR scores for nasal form, nasal symmetry and nasolabial profile. For patients with unilateral cleft lip with or without palate (UCLP), this study found that a protocol combining NAM and primary rhinoplasty improved nasolabial outcomes while a protocol with NAM alone offered only limited benefits. For patients with BCLP, the available evidence remains inconclusive. Performing NAM in combination with primary rhinoplasty improves nasolabial aesthetics in patients with UCLP. PROSPERO (CRD4202128384).
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  • 文章类型: Journal Article
    这篇综述将比较使用数字工作流程制造的鼻肺泡成型板与常规制造方法或无干预的唇裂或腭裂婴儿的功效。
    使用一系列适用于上颌弓的板,鼻肺泡成型可降低唇裂或腭裂婴儿的口面部缺陷的严重程度。常规方法需要以短时间间隔多次患者就诊以进行治疗。数字工作流程可用于在一次约会中制造多个盘子,消除了人为错误,减少预约次数,与矫治器制造相比,为正畸团队分配更多的时间用于患者护理。
    这篇综述将考虑临床研究,这些研究报告了唇裂或腭裂婴儿数字鼻肺泡成型的结果,并将其与常规方法或无治疗方法进行比较。感兴趣的结果将是颅面形式的客观测量,鼻唇测量,或腭形。
    本审查将根据系统审查和荟萃分析(PRISMA)指南的首选报告项目进行。包括PubMed在内的数据库,Embase,科克伦口腔健康小组试验登记册,和ClinicalTrials.gov将使用适当的关键字进行搜索。将考虑英文出版物。根据标题和摘要进行筛选将在重复删除后进行,然后是全文阅读,根据纳入标准进行选择。从研究中提取的数据将被制成表格并评估偏倚风险。如果适用,将对合并数据进行荟萃分析.
    PROSPEROCRD42020186452。
    This review will compare the efficacy of nasoalveolar molding plates fabricated using a digital workflow to conventional fabrication methods or no intervention in infants with cleft lip or palate.
    Nasoalveolar molding reduces the severity of orofacial defects in infants with cleft lip or palate using a series of adaptable plates for the maxillary arch. The conventional method needs multiple patient visits at short intervals for treatment. A digital workflow can be used to fabricate multiple plates in one appointment, which eliminates human error, reduces the number of appointments, and allocates more time for patient care for the orthodontic team than appliance fabrication.
    This review will consider clinical studies that report the results of digital nasoalveolar molding in infants with cleft lip or palate and compare it to the conventional method or to no treatment. Outcomes of interest will be objective measures of craniofacial form, nasolabial measurements, or palatal form.
    This review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases including PubMed, Embase, Cochrane Oral Health Group Trial Register, and ClinicalTrials.gov will be searched using appropriate keywords. Publications in English will be considered. Screening based on titles and abstracts will be done after de-duplication, followed by full-text reading for selection based on the inclusion criteria. Data extracted from the studies will be tabulated and assessed for risk of bias. If applicable, a meta-analysis of the pooled data will be conducted.
    PROSPERO CRD42020186452.
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  • 文章类型: Journal Article
    UNASSIGNED: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications.
    UNASSIGNED: Retrospective systematic review.
    UNASSIGNED: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate.
    UNASSIGNED: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes.
    UNASSIGNED: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles.
    UNASSIGNED: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.
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  • 文章类型: Journal Article
    UNASSIGNED: The aim of this systematic review and meta-analysis was to investigate long-term treatment effects of nasoalveolar molding (NAM) in patients with unilateral cleft lip and palate (UCLP).
    UNASSIGNED: Included manuscripts met the following criteria: (1) involved patients with UCLP who received NAM; (2) included comparison group(s) who either received non-NAM passive presurgical infant orthopedic appliances (PSIO) or who did not receive any PSIO; (3) reported at least one objective or validated measure of nasolabial, craniofacial, or palatal form; and (4) had patient follow-up beyond 4 years of age.
    UNASSIGNED: A total of 12 studies were included in this review. Meta-analyses were possible for Asher-McDade parameters and cephalometric measurements. Compared to patients who did not receive any PSIO, those who underwent NAM therapy were more likely to have good to excellent frontal nasal form (Risk ratio: 2.4, 95% CI: 1.24-3.68) and vermillion border (Risk ratio: 1.8, 95% CI: 1.19-2.71). However, there were no statistically significant differences in cephalometric measurements between these groups. Additionally, there were no statistically significant differences between patients receiving NAM versus non-NAM PSIO. There was insufficient evidence to determine the impact of NAM on dental arch development.
    UNASSIGNED: The preponderance of evidence in this review suggests that NAM produces benefits in nasolabial aesthetic form when compared with no appliance-based presurgical treatment. However, there is insufficient evidence to conclude whether NAM produces such benefits when compared with other passive PSIOs.
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