Aim: To evaluate the changes in maxillary alveolar morphology in unilateral cleft lip palate infants treated with nasoalveolar molding(NAM). Setting and Design: Study was carried out in the orthodontic department associated with a operating cleft unit in a rural region of central India. Ten UCLP (unilateral cleft lip palate) infants less than 6 weeks of age were treated with NAM prior to surgical repair. Materials and Methods:Pre NAM and Post NAM study models of the UCLP infants were analyzed. Critical linear dimensions including inter- canine width, inter-tuberosity width, arch length and midline deviation were recorded at the different stages using a digital vernier caliper and compared. Statistical analysis were performed using SPSS 13.00 statistical software. Results: Results from this study showed that the width of the alveolar cleft showed a significant decrease with NAM. The arch length and width of the arch in the anterior region also showed a reduction with NAM. The intertuberosity width showed a statistically significant increase during treatment. The arch perimeter showed a significant increase with NAM. Conclusion: NAM was effective in reducing the severity of the initial cleft deformity mainly at the anterior portion of the maxillary arch.

Background: Various methods have been described for the primary surgical reconstruction of the unilateral cleft lip and palate deformity (UCLP) in infants. There have been several attempts at restoring the normal anatomy of the nose at the time of lip repair in the affected individuals with varying degrees of success. Presurgical nasoalveolar molding (PNAM) is a presurgical infant orthopedic procedure that attempts to target the nasal deformity leading to a more esthetic surgical repair. Objective: At our center we aimed to use PNAM to help in providing the surgical team with a better foundation for an easier and more esthetic single stage repair at the level of nose in addition to the lip and alveolus. Method: The infant nasal cartilages are amenable to correction in the first few weeks of life when they retain their plasticity. Three infants with complete unilateral cleft lip palate (CUCLP) were operated upon after a course of PNAM. No nasal stents were use after repair to retain the results. Results: PNAM reduced the extent of the cleft deformity and improved the anatomic relationship between the affected structures. Postoperative recovery was uneventful. Subjective evaluation immediate post surgery and at the time of palate repair reveals adequate nasolabial esthetics. Long term results of PNAM assisted repair are to be ascertained. Conclusions: The use of PNAM enables in reducing the severity of the deformity the surgical team has to tackle thereby enabling in a better and esthetic primary repair

Objectives The aim of this study is to compare and evaluate the clinical outcome of early loaded and unloaded implants in the interforaminal region of anterior mandible. Materials and Methods Five completely edentulous patients aged between 45 and 65 years were selected satisfying certain criteria. Four implants were placed in 33, 43, 35 and 45 regions; implants in 33 and 43 regions were loaded by a Dolder bar supported overdenture at 7th day. The implants at 35 and 45 regions were connected to 33 and 43 regions, respectively after 4 months. The implants were divided into two groups. Group I consisted of early loaded implants (implants in the region of 33 and 43) and Group II consisted of delayed loaded implants (implants in the region of 35 and 45). The implants were evaluated for various clinical parameters at 2, 4 and 6 month intervals after initial placement. Results There was significant increase in the bone to implant contact for unloaded implants as compared to early loaded at the end of 6 months of implant placement. There was increased marginal bone loss around early loaded implants as compared to unloaded implants at the end of 6 months. Clinical stability of early loaded implants was lower as compared to the unloaded implants at the end of 6 months. Survival rate for early loaded and unloaded implants was 100% at the end of 6 months with all implants in function. Conclusion Early loading of interforaminal mandibular implants demonstrated a highly acceptable clinical success at the end of 6 months. However, the bone density, marginal bone level and clinical stability were significantly lower for the early loaded implants as compared to unloaded implants.

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