Presurgical Orthodontic Effects In Infants With Unilateral Cleft Lip And Palate And The Changes Of Cleft Segments

Objective:This study was performed to observe the presurgical nasoalveolar molding (PNAM) effect and growth of unilateral cleft lip and palate (UCLP) patients using 3-dimensional analysis.Methods:The sample consisted of 18 UCLP infants(10 males and 8 Females)who were treated using presurgical nasoalveolar molding (PNAM) appliance. The maxillary models were obtained at the initial visit, after PNAM treatment 1 month before cheiloplasty. The 3-dimensional models were constructed using a laser scanning machine and 3-dimensional software. Reference points and lines, which were based on the anatomic structures, were identified and digitized on the 3D model.Results(:1)The PNAM treatment did not produce significant changes in the width between the most posterior ends of GS and LS (F-G). The width between the middle parts of GS and LS (D-I)was significantly decreased during the PNAM treatment (P<0.05).The widths of the cleft gap (B-K,TransB-K) showed continuous and significant decrease during the PNAM treatment (P<0.05). However, the PNAM treatment significantly reduced the sagittal cleft gap (SagB-K, P<0.05).(2)The PNAM treatment did not change the configuration of GS(B-D-F)or LS(K-I-G). Although the PNAM treatment significantly reduced the angle between the anterior parts of GS andF-G ((B-F)-(F-G),P<0.05), The angle between the anterior parts of LS and F-G ((K-G)-(F-G)) did not show significant change during the PNAM treatment.The same as the angle between the anterior parts of GS and LS (B-D)-(K-I).(3)The severity of midline deviation was significantly reduced during the PNAM treatment (P<0.05).Conclusion:The results from this study suggest that alveolar molding effects took place mainly in the anterior alveolar segment during PNAM treatment.