Tratamento pré-cirúrgico de paciente com fissura palatina pré-forame incisivo unilateral através de engenharia reversa – relato de caso clínico

Abstract

Objective: to report a clinical case of pre-surgical orthopedic treatment in a patient with pre-foramen unilateral cleft palate performed from the nasal-alveolar molding (NAM) constructed through reverse engineering (RE).Method: a 1-month-old male patient with complete unilateral cleft lip and palate on the left side was submitted to preoperative NAM-RE treatment. Initially the upper arch molding was carried out, followed by the scanning of the mold and, from this, a digital model was created to carry out the virtual planning of the case. After approval of the planning, the models that served as the basis for the preparation of the alveolar plates were printed. The alveolar plates were changed weekly and used associated with a nasal component and lip adhesive. In order to evaluate the success of NAM-RE, measurements of the width of the gap (F-F '), the width of the intercanine region (C-C') and the width of the intermolar region (M-M) in the initial moment (T0), pre-surgical (T1) and postoperative (T2).Results: the F-F 'measure had a total decrease (T0-T2) of 3.18 mm, with 1.09 mm occurring in the time interval of T0-T1 and 2.09 mm in T1-T2. The distances C-C' and M-M' showed an increase in their lengths at all times measured. C-C' showed a total increase of 3.48mm (T0-T2), with 2.41mm in the interval between T0-T1 and 1.07mm in the T1-T2 interval. The distance M-M' had a total increase (T0-T2) of 4.56mm, being 4.38mm in the interval of T0-T1e and 0.18mm in the interval of T1-T2.Conclusion: the NAM constructed from reverse engineering proved to be effective in nasoalveolar modeling, evidencing a decrease in the width of the fissure with better conformation of the alveolar segments. With ER, it was possible to reduce the number of visits and decrease the clinical time of each care.