Presurgical Nasoalveolar Molding Therapy Using Figueroa's NAM Technique in Unilateral Cleft Lip and Palate Patients: A Preliminary Study

2016 ◽  
Vol 40 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Shafees Koya ◽  
Sandeep Shetty ◽  
Akhter Husain ◽  
Mustafa Khader
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
South Indian Population ◽  
Modified Technique ◽  
Arch Width ◽  
South Indian ◽  
Photographic Analysis ◽  
Before And After ◽  
A Prospective Study ◽  
Nasoalveolar Molding

Objective: The objective of the study was to evaluate the results of nasoalveolar molding (NAM) in the treatment of patients with unilateral cleft lip and palate using a modified technique in a South Indian population. Study design: The design was a prospective study with blinded measurements. The sample constituted 10 complete unilateral cleft lip and palate (UCLP) patients who underwent NAM therapy by the same operator. Direct extra and intra oral anthropometric measurements were done using a digital vernier caliper before and after NAM therapy. A photographic evaluation was also done to rate the nasal deformity post NAM therapy. The differences between measurements were statistically analyzed using paired t tests. Results: The extra oral measurements revealed a statistically significant increase in bi-alar width, columellar length and width. The intraoral measurements demonstrated a statistically significant reduction in anterior alveolar cleft width. There was also a significant increase in arch width and greater and lesser segments length. All cases were rated as improved by the surgeons in photographic analysis. Conclusion: The study has quantitatively shown that the modified NAM therapy improved nasal asymmetry by columellar lengthening and effectively molded the maxillary alveolar arch.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Bilateral Cleft Lip and Palate: A Preliminary Study

2006 ◽  
Vol 43 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Adam L. Spengler ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jaime Gateno ◽  
James J. Xia
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
University Of Texas ◽  
Bilateral Cleft Lip ◽  
Before And After ◽  
Nasal Tip Projection ◽  
A Prospective Study ◽  
The University ◽  
Nasoalveolar Molding

Objective To evaluate the outcome of presurgical nasoalveolar molding therapy in the treatment of patients with bilateral cleft lip and palate. Design A prospective study with blinded measurements. Setting The Cleft and Craniofacial Clinic at the University of Texas at Houston Medical School, Houston, Texas. Patients Eight patients with bilateral cleft lip and palate, treated between 2002 and 2004. Interventions The starting age for presurgical nasoalveolar molding therapy was 34.9 days and the average length of the therapy was 212.5 days. Main Outcome Measures Measurements of intraoral and extraoral casts were performed, and statistical analyses were used to compare the differences between measurements before and after therapy. Results Intraoral measurements demonstrated that there was a statistically significant reduction of the premaxillary protrusion and deviation. There was also a significant reduction in the width of the larger cleft. Extraoral measurements revealed that there was a significant increase in the bi-alar width and in the columellar length and width. Moreover, there was a significant improvement in columellar deviation. Finally, the nostril heights of both sides were increased. Conclusion The authors have quantitatively shown that presurgical nasoalveolar molding therapy has significant advantages in the treatment of bilateral cleft lip and palate patients. It improves the nasal asymmetry and deficient nasal tip projection associated with bilateral cleft lip and palate. It also forces the protruded premaxillary segment into alignment with the dental alveolar segments, improving the shape of the maxillary arch. As a result, the changes associated with presurgical nasoalveolar molding therapy help decrease the complexity of subsequent surgeries.

Presurgical Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate: A Preliminary Study

2007 ◽  
Vol 44 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Christopher F. Ezzat ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jung-Wei Chen ◽  
Robin G. Stratmann ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Significant Positive Correlation ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
Alveolar Cleft ◽  
Arch Width ◽  
Preliminary Study ◽  
A Prospective Study ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objective: To evaluate the outcome of presurgical nasoalveolar molding (PNAM) therapy in the treatment of patients with nonsyndromic unilateral cleft and palate (UCLP). Design: A prospective study with blinded measurements. Patients: Twelve patients with UCLP treated from 1997 to 2003. Interventions: The starting age for PNAM therapy was 26 days and the average length of the therapy was 110 days. Main Outcome Measures: Measurements of intraoral and extraoral casts were made, and statistical analyses were used to compare the differences between pre- and posttherapy measurements. Results: After PNAM therapy, there was a statistically significant decrease in both intersegment alveolar cleft distance and columellar deviation (p < .05). There was also a statistically significant increase in cleft nostril height, maxillary width, and columellar width (p < .05). Moreover, although there was no statistically significant reduction of the affected nostril width, it demonstrated on average 1.7-mm reduction after PNAM therapy. The length of the time the patient utilized the appliance and postmolding nostril height were found to have a statistically significant positive correlation (p < .05). Conclusions: PNAM therapy decreases intersegment alveolar cleft distance while permitting an increase in posterior maxillary arch width. It also increases nasal symmetry by decreasing columellar deviation, increasing nostril height on the affected side, maintaining bialar width of nose, increasing columellar width, and creating more symmetrical nostril heights and widths. The improvement of the height of the cleft nostril was correlated with the time the appliance was applied.

Spontaneous Growth of the Palatal Plates in the Cleft Lip and Palate

2020 ◽  
pp. 105566562098278
Author(s):  
Felipe Pontes ◽  
Gabriella Callegaris ◽  
Renato da Silva Freitas
Keyword(s):  
Prospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Posterior Arch ◽  
Arch Width ◽  
A Prospective Study ◽  
3D Software ◽  
Nasoalveolar Molding ◽  
Plaster Models ◽  
Presurgical Orthopedics

Objective: This is a prospective study examining palatal casts from patients with unilateral cleft lip and palate (UCLP) in the first month of life, immediately before cheiloplasty, and immediately before palatoplasty. None of the patients receives presurgical orthopedics (nasoalveolar molding). Design: In this prospective study, upper arch plaster models were taken 3 times during the treatment: in the first month of life (T1), before the cheiloplasty (T2), and before the palatoplasty (T3). Anatomic landmarks were defined and linear anthropometric measurements were obtained afterward. Dimensional analysis was performed using 3D software. Two-way analysis of variance followed by Tukey test was performed for statistical analysis. Setting: Tertiary, institutional. Participants: Twelve patients with UCLP of either sex with less than 1 month of life and without any other syndrome. Intervention: No intervention was performed. Main Outcome Measure: Reduction of the cleft without using orthopedics apparatus. Results: There was a statistically significant reduction in the cleft gap comparing T1 to T3. There was also a significant reduction in the intercanine width comparing T2 and T3, and T1 and T3. There was significant increase in the posterior arch width comparing T2 and T3, and T1 and T3. The palatal plate’s width increased in all times analyzed. Conclusion: The palatal cleft narrows spontaneously as well in both midpoint and posterior point during the first 6 months of patient’s treatment. This event was enhanced by cheiloplasty. This surgery might have a greater influence on the anterior arch width than in the posterior arch region.

Short-Term Efficacy of Presurgical Vacuum Formed Nasoalveolar Molding Aligners on Nose, Lip, and Maxillary Arch Morphology in Infants With Unilateral Cleft Lip and Palate: A Prospective Clinical Trial

2020 ◽  
pp. 105566562096618
Author(s):  
Khadega Ali Al Khateeb ◽  
Mai Aboul Fotouh ◽  
Fatma Abdelsayed ◽  
Fady Fahim
Keyword(s):  
Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Prospective Clinical Trial ◽  
Posterior Arch ◽  
Digital Models ◽  
Short Term ◽  
Arch Width ◽  
Nasoalveolar Molding ◽  
Maxillary Arch

Objectives: The purpose of this study was to evaluate the short-term effect of series of preadjusted vacuum formed nasoalveolar molding VF NAM aligners on the morphology of nose, lip, and maxillary arch in infants with unilateral cleft lip and palate (UCLP). Design: Prospective clinical trial. Setting: Unilateral cleft lip and palate patients referred to outpatients’ clinic. Patients: Sixteen nonsyndromic infants with UCLP, less than 2 months of age were included from April 2017 to April 2018. Interventions: All infants received VF NAM therapy. Standardized digital frontal and basilar photographs and 3D digital models were taken before initiation of VF NAM therapy (T1) and after completion of VF NAM therapy (T2). Main Outcome Measure(s): Changes in morphology of the nose, lip, and maxillary arch. Results: Statistical analysis comparing T1 and T2 measurements was performed. Frontal and basilar photographic analysis showed a statistically significant reduction of columella displacement, interlabial gap distance, and nostril width at cleft side (CS), while the nasal height, nostril height at CS, nostril width at noncleft side (NCS), columella deviation angle, nasal tip protrusion, and nostril area at both CS and NCS increased significantly with VF NAM therapy. The nasal width, nostril height at NCS showed no significant change after presurgical VF NAM aligners therapy. The analysis of digital models demonstrated a statistically significant reduction of alveolar cleft width, anterior arch width, arch length, midline deviation, and palatal cleft width, while the posterior arch width and arch perimeter increased significantly with VF NAM therapy. Conclusion: Vacuum formed NAM therapy was effective in reducing the nasoalveolar deformities associated with infants with UCLP and improved the alveolar morphology and nasal symmetry.

Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial

2019 ◽  
Vol 5 (4) ◽  
pp. 319-331 ◽  
Author(s):  
M.S. Saad ◽  
M. Fata ◽  
A. Farouk ◽  
A.M.A. Habib ◽  
M. Gad ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treated Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Arch Width ◽  
Randomized Controlled ◽  
Nasoalveolar Molding ◽  
Modified Algorithm

Objectives: Quantitative assessment of 3-dimensional progressive changes of the maxillary geometry in unilateral cleft lip palate (UCLP) with and without nasoalveolar molding (NAM). Methods: The study was designed as a prospective 2-arm randomized controlled clinical trial conducted in parallel. Forty infants with nonsyndromic UCLP were randomly assigned into a NAM-treated group (n = 20) and non–NAM treated group (n = 20). A total of 120 laser-scanned maxillary casts were collected and blindly analyzed via a modified algorithm at T0 (initial visit; baseline), T1 (after 3 wk; first interval), and T2 (after 6 wk; second interval). The main outcome measures were the amount and rate of cleft gap changes, the midline position, and the transverse, sagittal, and vertical growth through intervals. Results: More than 50% of the cleft gap (56.42%; P < 0.001) was reduced in the first 3 wk of alveolar molding (AM). The end point of the AM was obtained in 6 wk (86.25%; P < 0.001); then, the kinks of the greater segment were noticed. The AM effect decreased as far as posterior; the anterior arch width reduced slightly (1.23%; P < 0.001), while the middle and posterior arches increased slightly (P > 0.999 and P = 0.288, respectively). The posterior arch width was the least changing and was considered a baseline, while the anterior was the pivot of the segment rotation. Both groups showed different patterns of segment rotation and sagittal growth. The non–NAM treated group showed a slight increase in cleft gap length, arch width, and midline position. Conclusion: Based on this study, it was concluded that the NAM treatment is effective in minimizing cleft severity and realigning maxillary segments without the deterioration of the transverse and vertical arch growth. Near follow-up visits are recommended to monitor the rapid gap reduction within the first 3 wk. Further trials are recommended to compare the outcomes regarding the sagittal growth to reference values ( ClinicalTrials.gov NCT03029195). Knowledge Transfer Statement: The results of this study will help clinicians understand nasoalveolar molding biomechanics that may improve the treatment outcomes for patients with unilateral cleft lip and palate. The trial data can be a valuable guide to the qualitative and quantitative predictive virtual molding in computer aided design–simulated nasoalveolar molding therapy. The modified algorithm can be used by researchers to quantify the rate, the sequence, and the direction of the maxillary segments movement in unilateral cleft lip and palate.

Effectiveness of Presurgical Nasoalveolar Molding Appliance in Infants With Complete Unilateral Cleft Lip and Palate

2021 ◽  
pp. 105566562110264
Author(s):  
Thao Thi Nhu Dinh ◽  
Dau Van Nguyen ◽  
Vu Hoa Anh Dien ◽  
Tham Khac Dong
Keyword(s):  
Treatment Outcome ◽  
Prospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Outcome Expectations ◽  
Ho Chi Minh City ◽  
3 Dimensional ◽  
Children's Hospital ◽  
Before And After ◽  
Nasoalveolar Molding

Objective: To assess the effectiveness of the presurgical nasoalveolar molding appliance among infants with unilateral cleft lip and palate. Methods: In this prospective study, 95 pairs of casts of infants with unilateral cleft lip and palate treated by presurgical nasoalveolar molding were selected at the Children’s Hospital 1 at Ho Chi Minh City, Vietnam. The average time of treatment was 3 months. All casts were scanned and measured using 3-dimensional technology before and after treatment. Paired t tests were applied for comparisons. Results: There was a statistically significant increase in the nostril height in cleft side ( P < .001), decrease in the nostril width and columella angle ( P < .001), and decrease in cleft width and midline deviation ( P < .001) after treatment with presurgical nasoalveolar molding appliance. Conclusions: Nasoalveolar molding appliance is effective in improving the morphology of nostril and maxillary alveolar. Understanding this helps orthodontists and surgeons in treatment outcome expectations.

Association of IRF6 (G820A) Gene Variant with Nonsyndromic Cleft Lip and Palate in South Indian Population

2014 ◽  
Vol 48 (4) ◽  
pp. 245-250
Author(s):  
Nidhi Rathore ◽  
RM Dharma ◽  
MR Dinesh ◽  
BC Amarnath ◽  
CS Prashanth ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Indian Population ◽  
Cleft Lip And Palate ◽  
South Indian Population ◽  
Gene Variant ◽  
South Indian
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