Diversities in presurgical orthopedics: A review

Abstract

In children with cleft lip and palate, it is essential to maintain harmony among several aspects of treatment such as growth, esthetics, function and psychosocial development since birth. Treatment of infants with cleft lip and palate has been associated with many marked advances in recent years. To obtain the best possible results, these can and should be incorporated into the cleft team treatment protocols. Deformities in cleft lip and palate exhibit diversities in severity and form, as the wider and complete clefts show significant nasolabial deformity. This article reviews the literature on background of early maxillary orthopedics, various appliances, which have been proposed to reduce the initial alveolar cleft defect and molding of the deformed nasal cartilages, benefits, longterm effects of the same.

The impact of passive alveolar molding vs. nasoalveolar molding on cleft width and other parameters of maxillary growth in unilateral cleft lip palate

“…Two more passive and well-known PSIO techniques are passive alveolar molding (PAM), which uses a modified Hotz appliance [ 10 , 11 ], and nasoalveolar molding (NAM) according to Grayson [ 4 , 12 – 16 ]. The principle of both techniques is to guide alveolar arch growth using functional appliances (acrylic plates).…”

“…Treatment with PAM solely uses passive growth guidance by directing the movement of the alveolar segments using these grinding strategies [ 10 , 11 ]. On the other hand, NAM not only uses the grinding and adding strategy but also has a more active effect on the alveolus by using extraoral taping on the cheeks, thus applying direct transversal forces on the lip segments and indirectly exerting pressure on the alveolar ridge [ 4 , 12 – 14 ]. Additionally, NAM also uses one extraoral nasal stent for uCLP malformation, which helps to form the flattened and asymmetrical nostrils prior to lip surgery.…”