Three-Dimensional Comparison in Palatal Forms Between Modified Presurgical Nasoalveolar Molding Plate and Hotz's Plate Applied to the Infants With Unilateral Cleft Lip and Palate

Abstract

The presurgical nasoalveolar molding plate appliance with stent (PNAM) extended from the palatal molding plate; to correct the nostril shape of infants with cleft lip and palate is well known. The PNAM appliance is based on the finding that a high degree of plasticity is maintained in the cartilage of infants during the first 6 weeks after birth. However, on the current PNAM protocol described by Grayson et al. the nasal stent is supposed to be an adjunct to the palatal molding plate after reducing the severity of the alveolar cleft width. We have used the modified Hotz's plate from the setup model and built up the nasal stent even before reducing the severity of the alveolar deformity. In this study we assess the effects of the modified Hotz's plate and the modified PNAM appliance for the alveolar and palatal form. The lateral deviation of the incisal point, the width of the palatal cleft, and the degree of curvature of the palatal vault were first evaluated on plaster models. The PNAM group is smaller on the lateral deviation of the incisal point than the modified Hotz's group. The decreased average width of the palatal cleft and curvature of the palate, was almost the same in both the modified Hotz's and PNAM groups. In comparison with the modified Hotz's plate, the modified PNAM appliance also improves the molding of the alveolar segments and reduces cleft width.

Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity

“…A previous study reported that a significant difference of width of alveolar gap was not seen over time in patients treated with or without PNAM. 41 In the present study, we demonstrated successful treatment in patients with an alveolar cleft gap of more than 6 mm by PNAM. More successful results may be obtained when a smaller cleft remains between the alveolar ridges.…”

Three-dimensional evaluation of alveolar changes induced by nasoalveolar molding in infants with unilateral cleft lip and palate: A case-control study

“…Moreover, leveling of the alveolar structures, which support the nose and lip segments, provides a better environment for appropriate soft tissue molding 19. While a few studies have investigated the effects of NAM at the level of the alveolus,1112131415161721 they mostly evaluated transverse and sagittal alveolar changes induced by the treatment 1314151617. However, assessment of the vertical dimensions of the alveolar segments after treatment, which can result in vertical malalignment or insufficient vertical growth, is very crucial.…”

Effects of pre‐surgical nasoalveolar moulding on maxillary arch and nasal form in unilateral cleft lip and palate before lip surgery

“…It has been reported that PNAM treatment can mould the deformed nasal cartilage into a more symmetrical form and position and lengthen the deficient columella . This treatment is also useful for moulding the alveolar processes and narrowing the alveolar cleft to improve symmetry . However, evidence of the effectiveness of various types of infant orthopaedics, including PNAM, is limited .…”

“…[3][4][5][6][7] This treatment is also useful for moulding the alveolar processes and narrowing the alveolar cleft to improve symmetry. [8][9][10][11] The first and second authors made equal contributions to this study.…”