Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate Improves Nasal Symmetry and Maxillary Alveolar Dimensions

Ruíz-Escolano, María Gloria; Martínez-Plaza, Adoración; Fernández-Valadés, Ricardo; Cortés-Sánchez, Rosario; Muñoz-Miguelsanz, María Angeles; Ortega, Eugenio Velasco; Perez-Ureña, María Bélen; Matar-Satuf, Kamel; España-López, Antonio

doi:10.1097/scs.0000000000003047

Cited by 25 publications

(20 citation statements)

References 18 publications

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“…However, the overall results and trends were comparable with the outcomes of other studies. This indicates that the aims of nasoalveolar molding, namely the improvement of nasal symmetry, columella elongation, increasing of nostril height on the cleft side and raising the columella angle, have all been achieved 23 – 25 . The additional correction of nasal symmetry will be increased again when surgical lip closure is performed.…”

Section: Discussionmentioning

confidence: 96%

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Grill

Ritschl

Dikel

et al. 2018

Sci Rep

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Nasoalveolar molding (NAM) aims to improve nasal symmetry with a nasal stent in cleft lip and palate (CLP) patients. When plates have to be exchanged because of dentoalveolar growth or cleft reduction, the nasal stent has to be mounted onto a new plate. This procedure elongates visiting hours for patients and parents or requires second treatment sessions. This study introduces a quick-lock additive manufacturing solution for chairside nasal stent exchange called RapidNAM. A novel taping retention pin has been designed that enables nasal stent insertion. Patients with unilateral CLP were included in this study. Plaster models were digitalized and measured by two independent observers. Two methods of CAD/CAM-molding therapies were compared: (i) conventional adhesion of a nasal stent (CAD/CAM NAM); (ii) quick-lock system in which the nasal stent was transferred to another plate (RapidNAM). CAD/CAM NAM and its refinement RapidNAM significantly increased the cleft-side nasal height and tilted the nose towards symmetry. The quick-lock system minimizes wire adaptations, since the pre-existing stent can be reused. The new nasal stent development seems a feasible solution to minimize visiting hours but with clinically satisfactory results. This new nasal stent system combines traditional elements of NAM with CAD/CAM-technology.

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Section: Discussionmentioning

confidence: 96%

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Grill

Ritschl

Dikel

et al. 2018

Sci Rep

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“…This finding has been observed previously in studies both on children who have received PNAM prior to surgery and on those who have received no presurgical orthodontic treatment. 7,8,10 The current study should be viewed keeping in mind certain limitations. The greatest limitation of the study is the fact that the OHRQoL of the test group was only compared to children who were free of cleft rather than children with cleft lip and palate who had not undergone PNAM.…”

Section: Discussionmentioning

confidence: 97%

“…6 Benefits of this technique include nasal symmetry after lip and palate closure surgery, 1,7 and reduction in the number of surgical revisions of excessive scaring, oronasal fistula, and nasal and labial deformities 6,8 and improvement of maxillary dental arch shape. 9,10 However, despite the many reported advantages, this technique is time consuming, is expensive and requires parental compliance. 1 These factors have meant that PNAM is not universally practiced in all cleft centers.…”

Section: Introductionmentioning

confidence: 99%

Impact of Presurgical Nasoalveolar Molding on the Parental Perceptions of Oral Health-related Quality of Life of Children with Cleft Lip and Palate

AlAnazi

AlHayyan

Pani

2020

The Journal of Contemporary Dental Practice

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Aim:The study aimed to examine the oral health-related quality of life (OHRQoL) of children with cleft lip and palate who were treated with presurgical nasoalveolar molding (PNAM) and to compare the results to age-and gender-matched controls without cleft lip and palate. Materials and methods: Parents of 51 children with cleft lip and palate who were treated with PNAM were administered a validated Arabic version of the short-form child oral health impact profile (COHIP-SF) and were asked to rate their experience with PNAM. The children with treated cleft lip and palate (study group) were age-and gender-matched to children with no cleft lip and palate (control group). The differences in COHIP-SF domains were compared between groups using the Mann-Whitney U test. Results: The children in the test group had significantly higher COHIP-SF scores than in the test group (p < 0.001). However, there were no significant differences in the oral health (p = 0.532) or the oral function (0.232) domains. There were, however, significant differences in the socioemotional domain (p < 0.001). Most of the parents (86%) of children with cleft lip or palate felt that they would recommend PNAM to other parents. Conclusion: While there are no differences in the oral health and functional domains of OHRQoL, children with cleft lip and palate treated with PNAM have significantly lower scores in the socioemotional domain of OHRQoL when compared to age-and gender-matched controls. Clinical significance: Presurgical nasoalveolar molding does not have any negative impact on the OHRQoL of children with cleft lip and palate. Keywords: Cleft lip and palate, Oral health-related quality of life, Presurgical nasoalveolar molding.

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“…In the transverse plane, the anterior and posterior cleft width shows a statistically significant decrease, which corresponds with the previous studies despite the different types of nasoalveolar molding techniques. 26,13,27,28,29,7,8,5,30,31,14 The mean of anterior cleft width after using the modified NAM was 4.41 mm. In the previous studies using the active molding plate, the post-NAM anterior cleft width was 2.74–4.75 mm.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional Changes of Maxillary Alveolar Morphology After Using Modified Nasoalveolar Molding in Patients with Complete Unilateral Cleft lip and Palate

Chaisooktaksin

Chimruang

Worasakwutiphong

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective This study aimed to evaluate the three-dimensional changes in maxillary alveolar morphology after using modified NAM in patients with complete unilateral cleft lip and palate. Design This is a retrospective study. Setting The study was carried out in the dental hospital, Faculty of Dentistry of Naresuan University, Phitsanulok, which serves as a tertiary care center. Patients The population sample consisted of 19 patients with nonsyndromic complete unilateral cleft lip and palate. Intervention All patients received the modified NAM treatment based on the treatment protocol of the Naresuan University Cleft and Craniofacial Center, Thailand. Main Outcome Measure Dental models obtained at pre-treatment (T0) and post-treatment (T1) were scanned to construct the digital models. The maxillary digital models that showed dimensional changes between T0 and T1 were measured using a computer graphic software. Results The modified NAM resulted in a significant decrease in the anterior cleft width, posterior cleft width, and anterior arch width. Conversely, it caused a significant increase in the length of the lesser cleft segment and the greater segment rotation. However, the change in the height of both segments and posterior arch width was not found to be significant. Conclusions The modified NAM was an effective device for reducing the alveolar cleft width while improving the alignment of alveolar cleft segments.

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Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate Improves Nasal Symmetry and Maxillary Alveolar Dimensions

Cited by 25 publications

References 18 publications

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Impact of Presurgical Nasoalveolar Molding on the Parental Perceptions of Oral Health-related Quality of Life of Children with Cleft Lip and Palate

Three-dimensional Changes of Maxillary Alveolar Morphology After Using Modified Nasoalveolar Molding in Patients with Complete Unilateral Cleft lip and Palate

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