Pub Date : 2025-09-15DOI: 10.1053/j.sodo.2025.09.011
R.V. Haddad , M. Saadeh , N. Abou Chebel , J.G. Ghafari
Naso-alveolar molding (NAM) has been promoted as a presurgical infant orthopedic adjunct procedure for cleft lip/palate (CL/P) to achieve improved lip closure and nasal symmetry.
Aim
to review current evidence on the benefits and practical limitations of NAM.
Results
NAM can reduce presurgical cleft severity by minimizing tissue tension during surgery, improve nasolabial form (notably nostril height, bialar width, and columellar length), and cut the need for early revisions. NAM is particularly indicated for wide unilateral and bilateral clefts. Complications are usually minor but frequent: soft-tissue irritation, intranasal inflammation, appliance instability, and parental burden for appliance management. Innovative modifications of the NAM appliance might lessen limitations.
Conclusion
NAM is an efficient orthopedic tool to improve surgical lip closure and nose form, especially with designs easily and correctly used by parents. Knowledge gaps and research priorities are identified.
{"title":"Potential and limitations of naso-alveolar molding in patients with oral cleft","authors":"R.V. Haddad , M. Saadeh , N. Abou Chebel , J.G. Ghafari","doi":"10.1053/j.sodo.2025.09.011","DOIUrl":"10.1053/j.sodo.2025.09.011","url":null,"abstract":"<div><div>Naso-alveolar molding (NAM) has been promoted as a presurgical infant orthopedic adjunct procedure for cleft lip/palate (CL/P) to achieve improved lip closure and nasal symmetry.</div></div><div><h3>Aim</h3><div>to review current evidence on the benefits and practical limitations of NAM.</div></div><div><h3>Results</h3><div>NAM can reduce presurgical cleft severity by minimizing tissue tension during surgery, improve nasolabial form (notably nostril height, bialar width, and columellar length), and cut the need for early revisions. NAM is particularly indicated for wide unilateral and bilateral clefts. Complications are usually minor but frequent: soft-tissue irritation, intranasal inflammation, appliance instability, and parental burden for appliance management. Innovative modifications of the NAM appliance might lessen limitations.</div></div><div><h3>Conclusion</h3><div>NAM is an efficient orthopedic tool to improve surgical lip closure and nose form, especially with designs easily and correctly used by parents. Knowledge gaps and research priorities are identified.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 603-608"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Secondary alveolar bone grafting (SABG) is a cornerstone in the comprehensive management of patients with cleft lip and palate (CLP), essential for optimizing orthodontic outcomes and supporting esthetic and functional dental rehabilitation. While SABG has traditionally been performed between 9 and 11 years of age, an increasing number of multidisciplinary cleft teams, particularly in France, have adopted the Talmant protocol, which advocates for earlier grafting at 4 to 6 years of age. When performed prior to the eruption of permanent maxillary incisors and following orthodontic maxillary expansion when indicated, early SABG offers distinct advantages, including optimal surgical access, improved periodontal support, facilitated tooth eruption, and simplified orthodontic mechanics, without negatively impacting maxillary growth. However, specific challenges such as variable cooperation of younger patients, and considerations related to long term bone volume preservation in large clefts when permanent lateral incisors are congenitally missing must be acknowledged. This paper outlines the clinical rationale, indications, benefits, and limitations of early SABG and presents a detailed, patient-centered protocol built upon interdisciplinary collaboration between surgeons and orthodontists. Clinical cases are included to illustrate the protocol's practical implementation and long-term outcomes.
{"title":"Early Secondary Alveolar Bone Grafting in Cleft Lip and Palate at 5 Years of Age: Clinical Rationale, Benefits, and Protocol","authors":"Bruno Grollemund , Bieke kreps , Caroline Dissaux , Aurélie Majourau-Bouriez","doi":"10.1053/j.sodo.2025.08.007","DOIUrl":"10.1053/j.sodo.2025.08.007","url":null,"abstract":"<div><div>Secondary alveolar bone grafting (SABG) is a cornerstone in the comprehensive management of patients with cleft lip and palate (CLP), essential for optimizing orthodontic outcomes and supporting esthetic and functional dental rehabilitation. While SABG has traditionally been performed between 9 and 11 years of age, an increasing number of multidisciplinary cleft teams, particularly in France, have adopted the Talmant protocol, which advocates for earlier grafting at 4 to 6 years of age. When performed prior to the eruption of permanent maxillary incisors and following orthodontic maxillary expansion when indicated, early SABG offers distinct advantages, including optimal surgical access, improved periodontal support, facilitated tooth eruption, and simplified orthodontic mechanics, without negatively impacting maxillary growth. However, specific challenges such as variable cooperation of younger patients, and considerations related to long term bone volume preservation in large clefts when permanent lateral incisors are congenitally missing must be acknowledged. This paper outlines the clinical rationale, indications, benefits, and limitations of early SABG and presents a detailed, patient-centered protocol built upon interdisciplinary collaboration between surgeons and orthodontists. Clinical cases are included to illustrate the protocol's practical implementation and long-term outcomes.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 636-645"},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This review aimed to synthesize evidence on the anatomical and functional characteristics of the upper airway in individuals with cleft lip and palate (CLP), explore how alterations relates to occurrence of obstructive sleep apnea (OSA), and examined the efficacy and clinical applicability of diagnostic and therapeutic strategies, focusing on implications for interdisciplinary clinical practice.
Methods
This critical narrative review was conducted using a literature search performed between April and May 2025 in the databases PubMed, Scopus, and Embase. Studies published from 2020 to 2025 were prioritized, and earlier references were included to provide essential conceptual or methodological background. Main descriptors and keywords included: Obstructive Sleep Apnea, Cleft Lip, Cleft Palate, Upper Airways, Craniofacial Morphology, Cone-Beam Computed Tomography (CBCT), Computational Fluid Dynamics (CFD), and Polysomnography.
Results
Individuals with CLP often present reduced airway volume and increased risk for OSA. Anatomical changes increase airflow resistance; however, surgical interventions such as orthopedic maxillary expansion and orthognathic surgery may improve airway dimensions and sleep quality. Combining clinical assessment, CBCT, CFD, and polysomnography allows for an overall evaluation of individuals.
Conclusion
Management of OSA should be integrated into the craniofacial rehabilitation protocol for individuals with CLP and other craniofacial anomalies. Emerging technologies, such as digital sleep monitoring combined with artificial intelligence and assessment of upper airway dimensions, support early diagnosis, risk stratification, and the development of individualized therapeutic strategies.
{"title":"Obstructive sleep apnea and upper airway morphophysiology in orofacial clefts","authors":"Ivy Kiemle Trindade-Suedam , Thiago Henrique dos Santos Antunes Albertassi , Marcela Cristina Garnica-Siqueira , Sergio Henrique Kiemle Trindade","doi":"10.1053/j.sodo.2025.08.005","DOIUrl":"10.1053/j.sodo.2025.08.005","url":null,"abstract":"<div><h3>Objectives</h3><div>This review aimed to synthesize evidence on the anatomical and functional characteristics of the upper airway in individuals with cleft lip and palate (CLP), explore how alterations relates to occurrence of obstructive sleep apnea (OSA), and examined the efficacy and clinical applicability of diagnostic and therapeutic strategies, focusing on implications for interdisciplinary clinical practice.</div></div><div><h3>Methods</h3><div>This critical narrative review was conducted using a literature search performed between April and May 2025 in the databases PubMed, Scopus, and Embase. Studies published from 2020 to 2025 were prioritized, and earlier references were included to provide essential conceptual or methodological background. Main descriptors and keywords included: Obstructive Sleep Apnea, Cleft Lip, Cleft Palate, Upper Airways, Craniofacial Morphology, Cone-Beam Computed Tomography (CBCT), Computational Fluid Dynamics (CFD), and Polysomnography.</div></div><div><h3>Results</h3><div>Individuals with CLP often present reduced airway volume and increased risk for OSA. Anatomical changes increase airflow resistance; however, surgical interventions such as orthopedic maxillary expansion and orthognathic surgery may improve airway dimensions and sleep quality. Combining clinical assessment, CBCT, CFD, and polysomnography allows for an overall evaluation of individuals.</div></div><div><h3>Conclusion</h3><div>Management of OSA should be integrated into the craniofacial rehabilitation protocol for individuals with CLP and other craniofacial anomalies. Emerging technologies, such as digital sleep monitoring combined with artificial intelligence and assessment of upper airway dimensions, support early diagnosis, risk stratification, and the development of individualized therapeutic strategies.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 693-701"},"PeriodicalIF":2.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1053/j.sodo.2025.08.004
Puneet Batra , Aditya Talwar , Isha Duggal
Cleft lip and palate (CLP) are among the most common congenital craniofacial anomalies, presenting functional and aesthetic challenges that require a multidisciplinary treatment approach from infancy through adulthood. Presurgical infant orthopaedics (PSIO) are the early nonsurgical alveolar molding techniques to guide the growth and alignment of the maxillary segments before primary surgical repair, using appliances or taping techniques to improve cleft morphology and assist in lip repair.
The current review describes the development of PSIO in the early treatment of patients with cleft lip and palate anomaly, highlighting both its potential advantages and concerns. PSIO has been shown to facilitate surgical repair, improve nasal symmetry, columella lengthening, improve alveolar segments, and decrease the need for secondary surgical procedures. However, in addition to the continuous discussions about its effectiveness, there are still concerns with compliance, cost, and outcome variability, especially with the long-term effects of PSIO on speech development, facial growth, and psychosocial outcomes being debatable.
The present article enumerates contemporary practices and emerging trends, emphasizing the need for standardized protocols and robust evidence elaborating on the impact of PSIOs on facial growth, speech development, and psychosocial well-being. Ultimately, providing a balanced synthesis of current knowledge and outline future directions for individualized approaches supported by advances in digital technologies and personalized care to optimize treatment strategies in patients with cleft lip and palate.
{"title":"Balancing benefits and risks: Analyzing the short-term and long-term effects of presurgical infant orthopedic (PSIO) treatment in UCLP patients","authors":"Puneet Batra , Aditya Talwar , Isha Duggal","doi":"10.1053/j.sodo.2025.08.004","DOIUrl":"10.1053/j.sodo.2025.08.004","url":null,"abstract":"<div><div>Cleft lip and palate (CLP) are among the most common congenital craniofacial anomalies, presenting functional and aesthetic challenges that require a multidisciplinary treatment approach from infancy through adulthood. Presurgical infant orthopaedics (PSIO) are the early nonsurgical alveolar molding techniques to guide the growth and alignment of the maxillary segments before primary surgical repair, using appliances or taping techniques to improve cleft morphology and assist in lip repair.</div><div>The current review describes the development of PSIO in the early treatment of patients with cleft lip and palate anomaly, highlighting both its potential advantages and concerns. PSIO has been shown to facilitate surgical repair, improve nasal symmetry, columella lengthening, improve alveolar segments, and decrease the need for secondary surgical procedures. However, in addition to the continuous discussions about its effectiveness, there are still concerns with compliance, cost, and outcome variability, especially with the long-term effects of PSIO on speech development, facial growth, and psychosocial outcomes being debatable.</div><div>The present article enumerates contemporary practices and emerging trends, emphasizing the need for standardized protocols and robust evidence elaborating on the impact of PSIOs on facial growth, speech development, and psychosocial well-being. Ultimately, providing a balanced synthesis of current knowledge and outline future directions for individualized approaches supported by advances in digital technologies and personalized care to optimize treatment strategies in patients with cleft lip and palate.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 594-602"},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-17DOI: 10.1053/j.sodo.2025.08.006
Agneta Linder Aronson Karsten
To give birth to a child with a cleft of the lip, alveolus and/or palate is for many parents unexpected and the parents will experience different feelings the first days after delivery. Therefore, it is important that the medical and dental proffessions have evidence based treatments to offer. In many countries it is up to the parents to seek for information and treatments, whereas in other countries, there are multidisciplinary teams taking care of the planning, surgical reconstructions and other treatments eg. orthodontics from birth till adulthood. The goals for these teams are that the child breathes, eats, speaks, and feels well, have good craiofacial growth, a functional occlusion, a nice smile and a good self-esteem.
{"title":"Evidence based orthodontics – a narrative roadmap for contemporary clinical practise cleft lip and palate","authors":"Agneta Linder Aronson Karsten","doi":"10.1053/j.sodo.2025.08.006","DOIUrl":"10.1053/j.sodo.2025.08.006","url":null,"abstract":"<div><div>To give birth to a child with a cleft of the lip, alveolus and/or palate is for many parents unexpected and the parents will experience different feelings the first days after delivery. Therefore, it is important that the medical and dental proffessions have evidence based treatments to offer. In many countries it is up to the parents to seek for information and treatments, whereas in other countries, there are multidisciplinary teams taking care of the planning, surgical reconstructions and other treatments eg. orthodontics from birth till adulthood. The goals for these teams are that the child breathes, eats, speaks, and feels well, have good craiofacial growth, a functional occlusion, a nice smile and a good self-esteem.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 681-684"},"PeriodicalIF":2.0,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-13DOI: 10.1053/S1073-8746(25)00076-3
{"title":"FMii --- Table of Contents","authors":"","doi":"10.1053/S1073-8746(25)00076-3","DOIUrl":"10.1053/S1073-8746(25)00076-3","url":null,"abstract":"","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 4","pages":"Pages v-vi"},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-13DOI: 10.1053/S1073-8746(25)00075-1
{"title":"FMi --- Ed Board","authors":"","doi":"10.1053/S1073-8746(25)00075-1","DOIUrl":"10.1053/S1073-8746(25)00075-1","url":null,"abstract":"","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 4","pages":"Pages i-iv"},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the relationship between the degree of inferior turbinate descent (ITD), the width of the alveolar cleft (WAC) prior to secondary alveolar bone grafting (SABG), and the concavity of the alveolar bone bridge on the nasal side (CAB) in patients with unilateral cleft lip and palate (UCLP). The study included fourteen patients (seven males and seven females) who underwent SABG between the age of 8 and 11 years. One patient also underwent partial inferior turbinectomy (PIT) during SABG. Pre- and postoperative posteroanterior cephalograms were used to evaluate ITD and CAB. Additionally, in seven cases, WAC was measured using reconstructed computed tomography images taken before SABG. Scatter plot analysis was performed to examine the relationships among ITD, CAB, and WAC, and Spearman’s correlation test was used for statistical analysis. A significant correlation was observed between the ITD and CAB (p < 0.01). Furthermore, the scatter plots indicated that the depression on the bone bridge was reduced in the patients who underwent PIT. These findings suggest that a lower vertical position of the inferior turbinate may contribute to increased concavity of the nasal side of the alveolar bone bridge following SABG in patients with UCLP.
{"title":"Association between the vertical position of the inferior turbinate and alveolar bone bridge morphology after secondary alveolar bone grafting in patients with unilateral cleft lip and palate: A retrospective study","authors":"Masayoshi Uezono , Shiori Okubo , Takuya Ogawa , Keiji Moriyama","doi":"10.1053/j.sodo.2025.07.015","DOIUrl":"10.1053/j.sodo.2025.07.015","url":null,"abstract":"<div><div>This study aimed to investigate the relationship between the degree of inferior turbinate descent (ITD), the width of the alveolar cleft (WAC) prior to secondary alveolar bone grafting (SABG), and the concavity of the alveolar bone bridge on the nasal side (CAB) in patients with unilateral cleft lip and palate (UCLP). The study included fourteen patients (seven males and seven females) who underwent SABG between the age of 8 and 11 years. One patient also underwent partial inferior turbinectomy (PIT) during SABG. Pre- and postoperative posteroanterior cephalograms were used to evaluate ITD and CAB. Additionally, in seven cases, WAC was measured using reconstructed computed tomography images taken before SABG. Scatter plot analysis was performed to examine the relationships among ITD, CAB, and WAC, and Spearman’s correlation test was used for statistical analysis. A significant correlation was observed between the ITD and CAB (<em>p</em> < 0.01). Furthermore, the scatter plots indicated that the depression on the bone bridge was reduced in the patients who underwent PIT. These findings suggest that a lower vertical position of the inferior turbinate may contribute to increased concavity of the nasal side of the alveolar bone bridge following SABG in patients with UCLP.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 675-680"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1053/j.sodo.2025.07.011
Maria Costanza Meazzini
Early correction of maxillary hypoplasia in cleft lip and palate (CLP) patients is followed by major recurrence; therefore, maxillary protraction in the deciduous/early mixed dentition should be carried out mainly if significant functional problems are associated. On the contrary, long-term results of protraction applied close to growth peak, are more stable.
We describe our clinical approach using 3 subgroups. Group 1) Early treatment: 23 CLP patients affected by middle ear infection and hearing impairment were treated at an average age of 7.9 years with expansion and protraction face mask and compared to an age matched control. Audiometric tests and tympanograms improved in 82 % of the sample. Group 2) Adolescents with moderate-severe hypoplasia (<7 mm): 31 UCLP patients were treated with a Modified Alternate Rapid Maxillary Expantion and Constriction (Alt-Ramec) technique, at an average age of 12.5 years. Patients had adequate alveolar ossification, either after early secondary periosteoplasty or secondary alveolar bone grafting. The maxilla advanced 5.5 ± 2.3 mm and was stable in the long term (20.3 years). Group3) Adolescents with extremely severe hypoplasia (>8–10 mm): Thirteen very severe patients were treated with MART and traction with a Rigid External Distraction device (RED) for sutural protraction at an average age of 11.3 years. A-point advanced 16.4 ± 8.2 mm. Patients were followed short term for an average of 1.6 ± 0.8 years.
{"title":"Anteroposterior orthopedic management of maxillary deficiencies in patients with cleft lip and palate: treatment based on timing, indications and severity","authors":"Maria Costanza Meazzini","doi":"10.1053/j.sodo.2025.07.011","DOIUrl":"10.1053/j.sodo.2025.07.011","url":null,"abstract":"<div><div>Early correction of maxillary hypoplasia in cleft lip and palate (CLP) patients is followed by major recurrence; therefore, maxillary protraction in the deciduous/early mixed dentition should be carried out mainly if significant functional problems are associated. On the contrary, long-term results of protraction applied close to growth peak, are more stable.</div><div>We describe our clinical approach using 3 subgroups. Group 1) Early treatment: 23 CLP patients affected by middle ear infection and hearing impairment were treated at an average age of 7.9 years with expansion and protraction face mask and compared to an age matched control. Audiometric tests and tympanograms improved in 82 % of the sample. Group 2) Adolescents with moderate-severe hypoplasia (<7 mm): 31 UCLP patients were treated with a Modified Alternate Rapid Maxillary Expantion and Constriction (Alt-Ramec) technique, at an average age of 12.5 years. Patients had adequate alveolar ossification, either after early secondary periosteoplasty or secondary alveolar bone grafting. The maxilla advanced 5.5 ± 2.3 mm and was stable in the long term (20.3 years). Group3) Adolescents with extremely severe hypoplasia (>8–10 mm): Thirteen very severe patients were treated with MART and traction with a Rigid External Distraction device (RED) for sutural protraction at an average age of 11.3 years. A-point advanced 16.4 ± 8.2 mm. Patients were followed short term for an average of 1.6 ± 0.8 years.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 5","pages":"Pages 621-626"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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