Case Report
Keywords: 4D-alveolar molding (4D-AM) appliance; Shape-memory aligner for AM; Cleft lip and palate; Case Report; Direct-printed aligner therapy
Year : 2026 | Volume : 17 | Issue : 3 | Page : 68-78
Innovative Application of Direct Printed Shape Memory Aligners for Presurgical Alveolar Molding in a Preterm Infant with Unilateral Cleft Lip and Palate : 4D-AM Appliance: A Case Report
Pritam Mohanty-1, Krishna S-2, Om Prakash Kharbanda-3, Bikash Ranjan Bindhani-2
1-Professor and Head, 2-Postgraduate Resident, 3-Visiting Professor Emeritus, 4-Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Institute of Dental Sciences, Bhubaneswar, Odisha, India
Address for Correspondence:
Dr Pritam Mohanty, MDS, FCFO
Professor and Head,
Department of Orthodontics and Dentofacial Orthopedics
Institute of Dental Sciences, Bhubaneswar, Odisha, India
Email ID: pritammohanty@soa.ac.in
ABSTRACT
Presurgical nasoalveolar molding (PNAM) is an early intervention employed to reposition the alveolar segments and contour the cleft nasal dome, thereby enhancing surgical outcomes. Recent advances in PNAM include the use of thermoform aligners in newborns with clefts, but with certain limitations. Shape-memory aligners featuring dual-phase structures and stimulus-responsive properties deliver consistent, controlled molding, effectively overcoming the limitations of thermoformed aligners in orthodontic uses. This case demonstrates how direct‑printed shape‑memory aligners can be applied for alveolar molding in a premature infant. The infant had a Veau Class III cleft lip and palate and also a unilateral cleft lip nasal deformity. This particular use of aligners has not been widely reported in the literature. 11 sequential aligner trays were utilized to align the alveolar segments for primary surgical repair. We designated this approach the “4D-AM” appliance, which molds the alveolar segments in all three dimensions (3D), and is effective for a longer duration (4thD - time), owing to the shape-memory effect.
KEYWORDS: 4D-alveolar molding (4D-AM) appliance; Shape-memory aligner for AM; Cleft lip and palate; Case Report; Direct-printed aligner therapy
SOURCE OF FUNDING
Self
CONFLICT OF INTEREST
None
How to cite this article: Pritam Mohanty, Krishna S, Om Prakash Kharbanda, Bikash Ranjan Bindhani. Innovative Application of Direct Printed Shape Memory Aligners for Presurgical Alveolar Molding in a Preterm Infant with Unilateral Cleft Lip and Palate : 4D-AM Appliance: A Case Report.
Int J Orthod Rehabil 2026; 17 (3): 68-78.
Doi: 10.56501/Intjorthodrehabil.173.ijor0143