Premaxillay retraction in bilateral complete cleft lip and palate with custom made orthopaedic plate having anterior acrylic ring.

OBJECTIVE To determine retraction and alignment of protruded and rotated premaxillary segment and to measure increase in columellar length by using modified orthopaedic plate with anterior acrylic ring in newborn babies with non syndromic bilateral cleft lip and palate. METHODS Pre surgical infant orthopaedic treatment of ten non syndromic bilateral cleft lip and palate new born babies was done. Modified orthopaedic plate with anterior acrylic ring was used. This was adjusted every week by adding increments of 1 mm acrylic along the inner surface contacting labial surface of pre maxillary segment and trimming the same amount along the anterior margin of the plate. Pre and post treatment dental cast and a 1:1 photocopy of dental cast was obtained to analyze the retraction, angulations and arch form. Data was compiled and analyzed in SPSS 10. RESULTS A significant pre maxillary retraction, correction of rotation as well as increase of columellar length was achieved. CONCLUSION The appliance proved most successful being used immediately after birth, making use of plasticity of the neonate cartilage due to maternal estrogen levels. Moreover the appliance maintained arch form facilitated function and rendered initial lip repair easy and tension free.