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Early Progressive Maxillary Changes with Nasoalveolar Molding: Randomized Controlled Clinical Trial.
M S Saad1,2, M Fata3, A Farouk4
1Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
JDR Clinical and Translational Research
|December 21, 2019
Summary
Nasoalveolar molding (NAM) effectively reduces cleft gap severity in infants with unilateral cleft lip and palate (UCLP) within 6 weeks. This treatment realigns maxillary segments without negatively impacting transverse or vertical arch growth.
Area of Science:
- Craniofacial surgery
- Pediatric dentistry
- Orthodontics
Background:
- Unilateral cleft lip and palate (UCLP) presents complex challenges in maxillary geometry.
- Early intervention aims to improve long-term outcomes in UCLP patients.
- Nasoalveolar molding (NAM) is a common presurgical orthopedic treatment.
Purpose of the Study:
- To quantitatively assess 3D changes in maxillary geometry in UCLP patients.
- To compare the effects of nasoalveolar molding (NAM) versus no NAM.
- To evaluate the rate and amount of cleft gap reduction and arch changes.
Main Methods:
- Prospective, 2-arm randomized controlled clinical trial.
- Forty infants with nonsyndromic UCLP were randomized into NAM and non-NAM groups.
- 120 laser-scanned maxillary casts analyzed using a modified algorithm at baseline, 3 weeks, and 6 weeks.
Main Results:
- Over 50% cleft gap reduction occurred within the first 3 weeks of NAM.
- Significant cleft gap reduction (86.25%) achieved by 6 weeks.
- Anterior arch width reduced slightly, while middle and posterior arches increased slightly; non-NAM group showed increased cleft gap.
Conclusions:
- NAM effectively minimizes cleft severity and realigns maxillary segments without compromising transverse or vertical arch growth.
- Close follow-up is recommended to monitor rapid early gap reduction.
- Further research is needed to compare sagittal growth outcomes.
