A Comparative Cephalometric Study of Nasoalveolar Molding– and Non-Nasoalveolar Molding–Treated Bilateral Cleft Patients at Early Mixed Dentition Period

Abstract

Objective: To evaluate and compare early maxillary growth in 2 groups of patients with repaired bilateral cleft lip and palate (BCLP) who had and had not received nasoalveolar molding (NAM) therapy in infancy. Hypothesis: Nasoalveolar molding does not have any effect on maxillomandibular growth at the early mixed dentition period. Design: Retrospective study. Patients: The study group consisted of forty-two 7-year-old patients with BCLP—20 in the NAM group and 22 in the no-NAM group. The control group consisted of nineteen 7-year-old noncleft, normal patients. Interventions: Nasoalveolar molding was carried out prior to surgeries in those children who were brought in within 8 weeks of birth. Children brought in later were treated without a presurgical intervention. All patients were treated with a single-stage modified Millard cheiloplasty without gingivoperiosteoplasty. Palatoplasty was done by single-stage Bardach palatoplasty with muscle repositioning. Mean Outcome Measures: Hard tissue and dental cephalometric values measured on lateral cephalograms, recorded at 7 years of age. Results: A comparison of the mean sagittal values showed a statistically significant maxillomandibular retrusion and incisor retroclination of both BCLP groups in comparison to the control group. None of the cephalometric parameters varied statistically between NAM and no-NAM groups. The maxillomandibular relation, lower face height ratio, mandibular plane, and mandibular axis angles did not show statistically significant difference between all 3 groups. Conclusions: On the basis of this study, NAM does not have any effect on maxillomandibular growth at the early mixed dentition period.

Effects of nasoalveolar molding on maxillary arch dimensions and malocclusion characteristics in primary dentition patients with cleft lip and palate

“…In another study, cephalometric evaluation of skeletal and dental relationships in the early mixed dentition phase revealed no statistically significant difference between the NAM and non-NAM groups. 29 In the present study, the effects of NAM therapy on arch dimensions were examined in patients with BCLP in primary dentition, and no significant difference was observed between the NAM and non-NAM groups.…”

Three-Dimensional Nasolabial Changes After Nasoalveolar Molding and Primary Lip/Nose Surgery in Infants With Bilateral Cleft Lip and Palate

“…A comparison of surgery alone to a combination of NAM and primary rhinoplasty with overcorrection showed that patients receiving both had optimal results, closest to the nasal form of unaffected infants at 3 years of age (Chang et al, 2014). With respect to future growth, evidence shows that in evaluation of 7-year-old patients with BCLP, NAM did not have an effect of maxillomandibular growth compared to patients of the same age who underwent primary surgeries without presurgical NAM (Nayak et al, 2018).…”

Nasoalveolar molding: benefits and burdens

“…As a presurgical therapy, it improves predicted and actual postsurgical outcomes [36] . The evidence suggests an overall reduced total cost of care [37] due to decreased rates of secondary procedures [38,39] .…”