A Comparative Cost Analysis of Cleft Lip Adhesion and Nasoalveolar Molding before Formal Cleft Lip Repair

Abstract

Nasoalveolar molding may cost less before formal cleft lip repair treatment than cleft lip adhesion. Third-party payers who cover adhesion and not nasoalveolar molding may not be acting in their own best interest. Nasoalveolar molding places a higher burden of care on families, and this fact should be considered in planning treatment.

Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate: a systematic review

“…In addition to the clinical benefits and risks of labial adhesion, expenditure on health care became a subject of growing focus. A recent published study performed a retrospective comparative cost analysis of labial adhesion and nasoalveolar molding (Shay et al , ). This study demonstrated that nasoalveolar molding had distinct financial advantages over labial adhesion, but also placed a higher burden of care on families.…”

Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review

“…Among included studies, Shen et al [ 53 ] and Chen et al [ 54 ] evaluated the cost of cleft treatment and demonstrated that the NAM appliance has the potential to decrease the overall cost of cleft treatment. Two excluded retrospective studies confirmed this trend [ 30 , 31 ], NAM appeared indeed as a great mean to reduce the complexity, the number of the repair surgeries and subsequently the cost of care. One of them published by Shay et al in 2015 [ 31 ], gives interesting results and showed that the cost of a group of patients treated with NAM (mean costs $ 3550.24 ± $ 667.27) is significantly lower compare to a group of patients who received a surgical clef lip adhesion without NAM (mean costs $ 9370.55 ± $ 1691.79).…”

“…Two excluded retrospective studies confirmed this trend [ 30 , 31 ], NAM appeared indeed as a great mean to reduce the complexity, the number of the repair surgeries and subsequently the cost of care. One of them published by Shay et al in 2015 [ 31 ], gives interesting results and showed that the cost of a group of patients treated with NAM (mean costs $ 3550.24 ± $ 667.27) is significantly lower compare to a group of patients who received a surgical clef lip adhesion without NAM (mean costs $ 9370.55 ± $ 1691.79). No study related to parent’s cooperation during NAM therapy was included.…”

Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study

“…The so called "digital revolution" that affected dentistry over the last ten years now involves almost all the different dental specialties, making a growing number of manual tasks easier and faster to perform, cheaper, and more predictable [16]. It started with dental technicians' labs following the development of different systems of subtractive machining technology, which are now progressively integrated and sometimes substituted by additive processes for layered fabrication, and then included dental therapists, thanks to the diffusion of IOS and CAD-CAM systems designed to realize a chair-side restorative management of all individualized dental devices [40][41][42].…”

“…This is possible because of neonatal cartilage plasticity, due to high levels of circulating hyaluronic acid, that allow the correction of the nasal cartilage and soft tissue deformity [14]. Pre-surgical nasoalveolar molding results in long-term benefits to the patient and medical economics [15,16].…”