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Effect of Pre-Surgical Orthopedic Treatment on Hard and Soft Tissue Morphology in Infants with Cleft Lip and Palate
Saki Ogino1, Hitoshi Kawanabe2, Kazunori Fukui2
1Department of Dentofacial Orthopedics, Graduate School of Dentistry, Ohu University, 31-1, Misumido, Tomitamachi, Koriyama-City 963-8611, Fukushima, Japan.
Insights
Nasoalveolar molding (NAM) significantly reduced cleft width in infants with unilateral cleft lip and palate. This pre-surgical treatment improved both lip and jaw dimensions, aiding in early-stage management.
Area of Science:
- Craniofacial Surgery
- Pediatric Dentistry
- Orthodontics
Background:
- Unilateral cleft lip and palate (UCLP) affects approximately 0.146% of births in Japan.
- Early intervention is crucial for optimizing outcomes in infants with UCLP.
- Nasoalveolar molding (NAM) is a common pre-surgical orthopedic technique.
Purpose of the Study:
- To evaluate the effectiveness of NAM in improving nasal and alveolar morphology in infants with UCLP.
- To compare pre- and post-treatment measurements using 3D imaging and oral models.
Main Methods:
- A prospective study involving five infants with UCLP (mean age 37.6 days).
- 3D imaging and intraoral models were used for baseline and post-NAM treatment assessments.
- Measurements included cleft distance on 3D images and cleft jaw width on models.
Main Results:
- Significant reduction in cleft jaw width (mean 8.3 mm) after NAM treatment.
- Narrowing of cleft lip width at upper, middle, and lower points (averages 2.8 mm, 4.3 mm, 3.0 mm).
- NAM effectively reduced both cleft jaw and lip widths.
Conclusions:
- Pre-surgical orthopedic treatment with NAM is effective in narrowing the cleft jaw and lip in infants with UCLP.
- NAM shows promise for improving nasal morphology in the initial stage of treatment.
- Further studies with larger sample sizes are recommended to confirm these findings.
Abstract:
The frequency of cleft lip and palate births in Japan is approximately 0.146%. The study aimed to compare the effects of NAM on restoring nasal morphology and improving extraoral nasal morphology in children with cleft lip and palate in the first stage of treatment using 3D imaging and oral model analysis. The subjects were five infants (37.6 ± 14.4 days old) with unilateral cleft lip and palate. The images taken with the 3D analyzer and oral model used for constructing the NAM at the first examination (baseline) and at the completion of the pre-surgical orthodontic treatment (157.8 ± 37.8 days old) were analyzed. The cleft distance was measured at the upper, middle, and lower points on the 3D images. On the model, the cleft jaw width at the maximum protrusion of the healthy and affected sides of the alveolar bone was measured. After the pre-surgical orthopedic treatment, the measured value on the model decreased significantly by a mean of 8.3 mm from baseline, and the cleft lip width narrowed by an average of 2.8 ± 2.2, 4.3 ± 2.3, and 3.0 ± 2.8 mm at the upper, middle, and lower points of the cleft, respectively. Pre-surgical orthopedic treatment using NAM can help narrow the width of the cleft jaw and lip. The sample size is stated at the study limit in the paper.
