Long-Term Comparison of the Aesthetic Outcomes between Nasoalveolar Molding– and Non–Nasoalveolar Molding–Treated Patients with Unilateral Cleft Lip and Palate

2021 ◽  
Vol 148 (5) ◽  
pp. 775e-784e
Author(s):  
Tulasi Nayak ◽  
Krishnamurthy Bonanthaya ◽  
Renu Parmar ◽  
Pritham N. Shetty
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Aesthetic ◽  
Nasoalveolar Molding

scholarly journals Description of Nasoalveolar Molding Process in Neonatal Period of Unilateral Cleft Lip and Palate: A Step by Step

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohamed Azhari ◽  
Wijdane El Hawari ◽  
Hasnae Rokhssi ◽  
Nadia Merzouk ◽  
Oussama Bentahar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Treatment ◽  
Treatment Center ◽  
Congenital Defects ◽  
Molding Process ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Removable Appliances ◽  
Nasoalveolar Molding

Statement of problem. Cleft Lip and Palate (CLP) are common congenital defects of the present day. They result from a failure of facial bud sticking during embryological phenomena. Their therapeutics based on multi-disciplinary care to restore as much as possible the aesthetic and functional prejudices generated by these anomalies. Purpose. Through this work, we will illustrate, through a clinical case supported at the Consultation and Dental Treatment Center of Rabat, clinical and laboratory stages of realization of Nasoalveolar Molding (NAM). Material and methods. We describe original techniques used in our service for manufacturing of NAM fireworks and we define recommendations after insertion and follow-up procedures.Result. Place of NAM in management of these anomalies has increasingly recommended, given limitations of surgery alone to ensure satisfactory aesthetic results. Several fixed or removable appliances has used, in order to reposition gaps in cleft and / or to reshape affected bordering tissues. Conclusion. Despite the controversies surrounding this therapy, it remains highly recommended and scientifically based.

scholarly journals Long-Term Treatment Outcome of Presurgical Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate

2011 ◽  
Vol 22 (1) ◽  
pp. 333-336 ◽  
Author(s):  
Stacey L. Clark ◽  
John F. Teichgraeber ◽  
Ruth G. Fleshman ◽  
Joi D. Shaw ◽  
Carmen Chavarria ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Nasoalveolar Molding

scholarly journals A Longitudinal Study of The Nasal Symmetry in Unilateral Cleft Lip And Palate Patients Treated With Nasoalveolar Molding

2020 ◽  
Vol 53 (03) ◽  
pp. 371-376
Author(s):  
Tulasi Nayak ◽  
Renu Parmar ◽  
Krishnamurthy Bonanthaya ◽  
Pritham Shetty
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Conclusive Evidence ◽  
Long Term Stability ◽  
Alar Base ◽  
Gradual Loss ◽  
Nasoalveolar Molding

Abstract Background Nasoalveolar molding (NAM) has been extensively used as a presurgical technique in the treatment of unilateral cleft lip and palate (UCLP) over the last two decades. It has proven to be a useful tool to reduce the cleft size, improve nasal symmetry, and increase the columellar length. The long-term stability of these findings has not been conclusively proven. Methods In this longitudinal study, the nasal symmetry of 24 NAM treated UCLP patients was evaluated to assess the 5-year stability of NAM. The basal photographs were shot postcheiloplasty (T1), at 1-year follow-up (T2), at 3-year follow-up (T3), and 5-year follow-up (T4) appointments. Results In this study, we found that NAM was a useful adjuvant in achieving nasal symmetry in patients with UCLP in the immediate postoperative period. However, as the patients aged, there was a gradual loss of mean nasal height (by 22.83%) and columella length (by 24.89%), a mean gain in nasal width (by 40.25%) and alar base width (by 40.69%), and an increase in the columella deviation (by 3.46%) from the T1 to the T4 follow-up. Conclusion Although there is no conclusive evidence, the loss of symmetry may be due to the unequal growth on the cleft and noncleft sides. These patients will be followed-up till end of growth for a definite conclusion on the long-term effect of NAM.

Long-Term Effects of Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 105566562110097
Author(s):  
William M. Padovano ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Alison K. Snyder-Warwick ◽  
Kamlesh B. Patel
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Insufficient Evidence ◽  
Nasoalveolar Molding ◽  
Cephalometric Measurements ◽  
The Impact

Objective: The aim of this systematic review and meta-analysis was to investigate long-term treatment effects of nasoalveolar molding (NAM) in patients with unilateral cleft lip and palate (UCLP). Design: Included manuscripts met the following criteria: (1) involved patients with UCLP who received NAM; (2) included comparison group(s) who either received non-NAM passive presurgical infant orthopedic appliances (PSIO) or who did not receive any PSIO; (3) reported at least one objective or validated measure of nasolabial, craniofacial, or palatal form; and (4) had patient follow-up beyond 4 years of age. Results: A total of 12 studies were included in this review. Meta-analyses were possible for Asher-McDade parameters and cephalometric measurements. Compared to patients who did not receive any PSIO, those who underwent NAM therapy were more likely to have good to excellent frontal nasal form (Risk ratio: 2.4, 95% CI: 1.24-3.68) and vermillion border (Risk ratio: 1.8, 95% CI: 1.19-2.71). However, there were no statistically significant differences in cephalometric measurements between these groups. Additionally, there were no statistically significant differences between patients receiving NAM versus non-NAM PSIO. There was insufficient evidence to determine the impact of NAM on dental arch development. Conclusions: The preponderance of evidence in this review suggests that NAM produces benefits in nasolabial aesthetic form when compared with no appliance-based presurgical treatment. However, there is insufficient evidence to conclude whether NAM produces such benefits when compared with other passive PSIOs.

Knowledge and Attitude Among Various Dental Specialities Regarding Nasoalveolar Molding Procedure in Cleft Patients—A Cross-Sectional Study

2021 ◽  
pp. 105566562110174
Author(s):  
Divya Doddamani ◽  
Saraswathi V. Naik ◽  
Archana P. Betur ◽  
Sugandhan Suriyan ◽  
Basappa Nadig
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Orthopedic Procedure ◽  
Dental Practitioners ◽  
Significant Difference ◽  
Knowledge And Attitude ◽  
The Aesthetic ◽  
Nasoalveolar Molding

Background: Nasoalveolar molding (NAM) is a presurgical orthopedic procedure, mainly focusing upon the aesthetic outcome of the treatment goal by reducing the number of reconstructive surgeries performed later for the purpose of esthetics. It was reported a very small proportion of pediatric dentists are providing presurgical intervention and the practice of NAM still side stepping among various dental practitioners. Objectives: The study was aimed to assess the knowledge and attitude among various dental specialties regarding NAM procedure in cleft patients. Materials and Methods: A questionnaire-based cross-sectional survey was carried out among 180 dental professionals (pedodontists, orthodontists, prosthodontists, oral surgeons). A total of 180 questionnaires were prepared, out of which 98 were filled through direct personal interview and 82 were circulated via Google forms. Results were analyzed using chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. Results: There was statistically significant difference in the cumulative knowledge scores between specialty with P < .001; 99% of the participants think one should opt for NAM before cleft lip and palate surgery and 39% participants prefer pedodontists to carry out NAM procedure. Conclusion: Dental specialists in India have a positive attitude toward presurgical orthopedics. Majority of them agreed that there is great improvement in the aesthetic outcomes of surgeries after NAM intervention.

Prepubertal Midface Growth in Unilateral Cleft Lip and Palate following Alveolar Molding and Gingivoperiosteoplasty

2004 ◽  
Vol 41 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Catherine T. H. Lee ◽  
Barry H. Grayson ◽  
Court B. Cutting ◽  
Lawrence E. Brecht ◽  
Wen Yuan Lin
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Permutation Test ◽  
Long Term Effect ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Late Start ◽  
Nasoalveolar Molding

Objectives To examine the long-term effect of nasoalveolar molding and gingivoperiosteoplasty (modified Millard type) on midface growth at prepuberty. Procedures In this retrospective study, 20 consecutive patients with a history of complete unilateral cleft lip and palate were evaluated. Ten patients had nasoalveolar molding and gingivoperiosteoplasty performed at lip closure; 10 control patients had nasoalveolar molding but no gingivoperiosteoplasty because of late start in treatment or poor compliance. A single surgeon (C.B.C.) performed all surgical procedures. Standardized lateral cephalometric radiographs were evaluated at two time periods: T1 at pre–bone-grafting age and T2 at prepuberty age. Superimposition and cephalometric analysis were undertaken to investigate the two groups. Two cephalometric reference planes, sella-nasion and basion-nasion, were used to assess the vertical and sagittal relations of the midface (ANS-PNS). The reference landmarks were procrustes fitted. The mean location and variance of ANS and PNS landmarks were computed. All results were analyzed by permutation test. Results No significant difference in mean location or variance of ANS-PNS in both vertical and sagittal planes at both T1 and T2 periods were found between the two groups (p > .05). Conclusions The results suggested that midface growth in sagittal or vertical planes (up to the age of 9 to 13 years) were not affected by presurgical alveolar molding and gingivoperiosteoplasty (Millard type).

Objective Assessment of the Nasal Airway in Unilateral Cleft Lip and Palate - a Long-term Study

2009 ◽  
pp. 091202121239062
Author(s):  
Maria Mani ◽  
Staffan Morén ◽  
Ornolfur Thorvardsson ◽  
Olafur Jakobsson ◽  
Valdemar Skoog ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Objective Assessment ◽  
Nasal Airway ◽  
Term Study ◽  
Long Term Study

Treatment of Unilateral Cleft Lip and Palate Patient With Intraoral Tooth Tissue Borne Distractor and Facemask Therapy: A Case Report

2021 ◽  
pp. 105566562199336
Author(s):  
Akansha Bansal Agrawal ◽  
Harshavardhan Kidiyoor ◽  
Anand K. Patil Morth
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Rapid Maxillary Expansion ◽  
Growth Potential ◽  
Maxillary Expansion ◽  
Long Term Stability ◽  
Tooth Tissue

This case report demonstrates the successful use of intraoral distractor/hygenic rapid expander (HYRAX) for rapid maxillary expansion in anteroposterior direction with an adjunctive use of face mask therapy for anterior orthopedic traction of maxillary complex in a cleft patient with concave profile. The patient was a 13-year-old girl who reported with a chief complaint of backwardly positioned upper jaw and a severely forward positioned lower jaw. Therefore, a treatment was chosen in which acrylic bonded rapid maxillary expansion was done with tooth tissue borne intraoral distractor/HYRAX having a different activation schedule along with Dr Henri Petit facemask to treat maxillary retrognathism. As a result, crossbite got corrected and attained a positive jet with no bone loss in cleft area over a period of 5 months which was followed by fixed mechanotherapy achieving a well settled occlusion in 1 year. After completion of expansion and fixed mechanotherapy, ANB became +1 post-treatment which was −4 pretreatment. The prognathic profile was markedly improved by expansion and taking advantage of the remaining growth potential, thus minimizing the chances of surgery later in life. This provided a viable alternative to orthognathic surgery with good long-term stability.

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