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

Abstract

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.

Influence of presurgical nasoalveolar molding (PNAM) treatment in maxillary dental arch width and nasolabial symmetry in patients with unilateral complete cleft lip and palate

“…PNAM treatment can significantly render surgery less difficult, but the development of the dental arch can be negatively impacted [16]. Some researchers have suggested that the effects of PNAM on dental arch were temporary [17]. However, the findings in this paper indicated that PNAM treatment has a lasting negative impact on dental arch form, both in the short and long term.…”

Comparative Study of Maxillary Growth in Patients With Unilateral Cleft Treated With and Without Pre-Surgical Orthopedics

“…The use of Pre Surgical Infant Orthopedic (PSIO) is controversial: some studies have shown that its association with surgical treatment fosters a better nasal symmetry and reduces cleft severity. [1][2][3] Nevertheless, it has been reported that the use of PSIO is not always necessary for a proper alveolar growth, and previous studies suggest that the cleft size may be reduced without orthopedic devices. 4,5 Many studies have published case series of patients who were treated either with or without pre-surgical orthopedics, but few of them compare case series of patients with and without such treatment.…”

“…The use of Pre Surgical Infant Orthopedic (PSIO) is controversial: some studies have shown that its association with surgical treatment fosters a better nasal symmetry and reduces cleft severity. 1–3 Nevertheless, it has been reported that the use of PSIO is not always necessary for a proper alveolar growth, and previous studies suggest that the cleft size may be reduced without orthopedic devices. 4,5…”