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Through this research, we have presented a modified presurgical nasoalveolar molding (PNAM) device, protocol, and equipment of preoperative nasal alveolar formation techniques to improve lip, nose, alveolar, and palatal deformity in the Department of Orthodontics and Maxillo-Facial Department at the University of Prishtina. A two-week-old boy was brought to our Department of Orthodontics. The baby was diagnosed with non-syndrome bilateral complete cleft of the primary and secondary palate. After a complete examination and orthodontic therapeutic planning, precaution was taken for creating a PNAM appliance and sent to the laboratory. An intraoral molding plate was established on both sides of the separate segments of the maxilla and fixed with a mini screw to approximate the maxillary segments. Parts of the strings built in the front side activated (please check) and, together with the nasal stent, were added to correct the nose deformity. By using modified NAM to close the cleft segments, both the ones of the upper lip and the ones of the palate, we achieved the same results and reduced possible tissue damage by maintaining the conventional NAM apparatus. We used an alveolar formation plate with traction stainless steel to reduce the separate parts. Under this presurgical treatment, the cleft alveolus and palatal segments were reduced considerably. Also, the parts of the flatting nasals of the nose were set up. Through interdisciplinary work, we created a new modified NAM appliance to avoid the obstacles of the traditional NAM devices and to improve the presurgical treatment by using the benefits of the postnatal period of the child to have a more effective treatment. Despite the inability of previous studies to decide on the degree of efficacy of PNAM and the fact that scientific data is limited, we consider that our research can contribute to a better understanding of why it is essential to use PNAM and of the need to enhance the apparatus.

Background: Hypodontia of lateral incisors (LI) is frequently associated with other dental anomalies. The objective of this study was to determine the association of LI with other dental anomalies by comparing the two groups: Group 1 with hypodontia of the maxillary LI (MLI1) and Group 2 with hypodontia of the mandibular LI (MLI2), in secondary school education students in Kosovo. Methods and Results: A total of 3306 secondary school students aged 12-16 years, regardless of gender, were included in this prospective study. The abnormalities investigated were recorded by RTG-panoramic and dental charts. The teeth were recorded as a congenital absence when the mineralization of the crown, identified by panoramic tomography, was absent. The prevalence of LI hypodontia was as follows: MLI1 (Group 1) included 36 cases (92.3%) and MLI2 (Group 2) included only 3 cases (7.6%), which indicates a much higher percentage of cases with hypodontia of MLI1. In Group 1, 21(58.3%) cases of LI hypodontia were bilateral and 15(41.7%) unilateral; in Group 2, 2(66.7%) cases were unilateral and 1(33.3%) case – bilateral. Among dental anomalies, the occurrence of rotation was found in 19(48.7%) cases with LI hypodontia: 47.2% cases in Group 1 and 66.7% cases in Group 2. The prevalence of dental inclination anomaly was 30.77% of all cases with hypodontia of LI: 27.8% of cases in Group 1 and 66.7% of cases in Group 2. The prevalence of ectopy was in 17.9% of cases of all hypodontia cases of LI: 16.7% of cases in Group 1 and 33.3% of cases in Group 2. Crown anomalies were evident in 7(17.9%) patients of all hypodontia cases of LI, all of which were in Group 1. Other anomalies such as microdontia were evident in two patients in Group 1. Transposition, bodily movement, and superposition were present in one patient in Group 1; in Group 2, one patient had transposition. At the same time, the frequency of dental transposition was significantly higher in Group 2 than in Group 1 (P=0.02088). Other dental anomalies of crown and root and infraposition were not present in both groups. There were no significant differences in the other dental anomalies between the two groups. Conclusion: The consequences of hypodontia in dental arches are obvious. Knowing the prevalence of hypodontia and its association with other dental anomalies helps classify the need for further treatment for the patients, whether orthodontic, prosthetic, or surgical.