Download PDF
CC BY 4.0 · European Journal of General Dentistry 2023; 12(01): 007-013
DOI: 10.1055/s-0042-1760447
Review Article

Presurgical Nasoalveolar Molding—Efficacy and Biomechanics in Management of Cleft Lip and Palate: A Review of the Literature

Hussain M. Alkhames 
1   College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
,
Murali Venkata Rama Mohan Kodali 
2   Department of Oral and Maxillofacial Surgery, College of Dentistry, King Faisal University, Al-Hasa, Kingdom of Saudi Arabia
,
Elwalid Fadul Nasir
3   Department of Preventive Dental Services, College of Dentistry, King Faisal University, Al-Hasa, Kingdom of Saudi Arabia
,
Mohamed Hassan
3   Department of Preventive Dental Services, College of Dentistry, King Faisal University, Al-Hasa, Kingdom of Saudi Arabia
,
Unati Sai Kodali
4   Medical House Surgeon, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Dr. NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India
› Author Affiliations Funding This work was supported through the Deanship of Scientific Research, Vice Presidency for Graduate Studies and Scientific Research, King Faisal University, Saudi Arabia with grant number 1193.
› Further Information
   Permissions and Reprints

Abstract

Presurgical infant orthopaedics (PSIO) appliances are used in the management of cleft lip and palate. Frequently, among all PSIO appliances utilized is presurgical nasoalveolar molding (NAM) appliance. In this review, we looked for the application of the NAM appliance, its efficacy, and biomechanics. A comprehensive search strategy was performed in two databases (Google Scholar and PubMed) for articles using NAM in the treatment plan of patients with cleft lip and palate. Six articles were included in this study with one randomized control trial, two retrospective, and three case reports studies. The studies reveal the NAM is efficient as a presurgical modality treatment for complete cleft lip and palate with multiple benefits, including reducing surgical scars and alveolar gap, used as feeding plate, improve nasal contour, and decreased the number of rectifying surgical procedure.

Keywords

nasoalveolar molding - biomechanics - presurgical orthopedics - cleft lip - cleft palate


Publication History

Article published online:
06 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet 2011; 12 (03) 167-178
    CrossrefPubMedGoogle Scholar
  • 2 Salari N, Darvishi N, Heydari M, Bokaee S, Darvishi F, Mohammadi M. Global prevalence of cleft palate, cleft lip and cleft palate and lip: a comprehensive systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2022; 123 (02) 110-120
    CrossrefPubMedGoogle Scholar
  • 3 Wang XX, Wang X, Li ZL. et al. Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report. Int J Oral Maxillofac Implants 2009; 38 (12) 1237-1243
    CrossrefPubMedGoogle Scholar
  • 4 Grayson BH, Santiago PE, Brecht LE, Cutting CB. Presurgical nasoalveolar molding in infants with cleft lip and palate. Cleft Palate Craniofac J 1999; 36 (06) 486-498
    CrossrefPubMedGoogle Scholar
  • 5 Hunt O, Burden D, Hepper P, Johnston C. The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthod 2005; 27 (03) 274-285
    CrossrefPubMedGoogle Scholar
  • 6 Roy AA, Rtshiladze MA, Stevens K, Phillips J. Orthognathic surgery for patients with cleft lip and palate. Clin Plast Surg 2019; 46 (02) 157-171
    CrossrefPubMedGoogle Scholar
  • 7 Wornom IL, Will LA, Burdi AR, Berkowitz S, Breen ML, Clarke-Sheehan N, Curtin VM, D'Antonio LL, Friedman CD, Gleason AT, Huebener DV. Core curriculum for cleft lip/palate and other craniofacial anomalies: A guide for educators. InCleft Lip and Palate 2006; 285-300 . Springer Berlin Heidelberg
    Google Scholar
  • 8 Shi B, Losee JE. The impact of cleft lip and palate repair on maxillofacial growth. Int J Oral Sci 2015; 7 (01) 14-17
    CrossrefPubMedGoogle Scholar
  • 9 Bhutiani N, Tripathi T, Verma M, Bhandari PS, Rai P. Assessment of treatment outcome of presurgical nasoalveolar molding in patients with cleft lip and palate and its postsurgical stability. Cleft Palate Craniofac J 2020; 57 (06) 700-706
    CrossrefPubMedGoogle Scholar
  • 10 Ma L, Hou Y, Liu G, Zhang T. Effectiveness of presurgical orthodontics in cleft lip and palate patients with alveolar bone grafting: a systematic review. J Stomatol Oral Maxillofac Surg 2021; 122 (01) 13-17
    CrossrefPubMedGoogle Scholar
  • 11 Isik Aslan B, Gülşen A, Findikçioğlu K, Uzuner D, Üçüncü N. Effects of nasoalveolar molding therapy on alveolar and palatal cleft deformities in unilateral and bilateral cleft lip and palate. J Craniofac Surg 2018; 29 (02) e179-e184
    CrossrefPubMedGoogle Scholar
  • 12 Saad MS, Fata M, Farouk A. et al. Early progressive maxillary changes with nasoalveolar molding: randomized controlled clinical trial. JDR Clin Trans Res 2020; 5 (04) 319-331
    PubMedGoogle Scholar
  • 13 Staderini E, Patini R, Camodeca A, Guglielmi F, Gallenzi P. Three-dimensional assessment of morphological changes following nasoalveolar molding therapy in cleft lip and palate patients: a case report. Dent J 2019; 7 (01) 27
    CrossrefPubMedGoogle Scholar
  • 14 Rubin MS, Clouston SAP, Esenlik E, Shetye PR, Flores RL, Grayson BH. Midface growth in patients with unilateral cleft lip and palate treated with a nasoalveolar molding protocol. J Craniofac Surg 2019; 30 (06) 1640-1643
    CrossrefPubMedGoogle Scholar
  • 15 Hotz M, Gnoinski W. Comprehensive care of cleft lip and palate children at Zürich university: a preliminary report. Am J Orthod 1976; 70 (05) 481-504
    CrossrefPubMedGoogle Scholar
  • 16 Peat JH. Early orthodontic treatment for complete clefts. Am J Orthod 1974; 65 (01) 28-38
    CrossrefGoogle Scholar
  • 17 Millard Jr DR, Latham RA. Improved primary surgical and dental treatment of clefts. Plast Reconstr Surg 1990; 86 (05) 856-871
    CrossrefPubMedGoogle Scholar
  • 18 Goldwyn RM, Hullihen SP. Simon P. Hullihen: pioneer oral and plastic surgeon. Plast Reconstr Surg 1973; 52 (03) 250-257
    CrossrefPubMedGoogle Scholar
  • 19 Grayson BH, Cutting C, Wood R. Preoperative columella lengthening in bilateral cleft lip and palate. Plast Reconstr Surg 1993; 92 (07) 1422-1423
    PubMedGoogle Scholar
  • 20 Matsuo K, Hirose T, Tomono T. et al. Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Plast Reconstr Surg 1984; 73 (01) 38-51
    CrossrefPubMedGoogle Scholar
  • 21 Cutting C, Grayson B, Brecht L, Santiago P, Wood R, Kwon S. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg 1998; 101 (03) 630-639
    CrossrefPubMedGoogle Scholar
  • 22 Matsuo K, Hirose T, Otagiri T, Norose N. Repair of cleft lip with nonsurgical correction of nasal deformity in the early neonatal period. Plast Reconstr Surg 1989; 83 (01) 25-31
    CrossrefPubMedGoogle Scholar
  • 23 Santiago PE, Grayson BH, Cutting CB, Gianoutsos MP, Brecht LE, Kwon SM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J 1998; 35 (01) 77-80
    CrossrefPubMedGoogle Scholar
  • 24 Maull DJ, Grayson BH, Cutting CB. et al. Long-term effects of nasoalveolar molding on three-dimensional nasal shape in unilateral clefts. Cleft Palate Craniofac J 1999; 36 (05) 391-397
    CrossrefPubMedGoogle Scholar
  • 25 Khurshid Z, Tariq R, Asiri FY, Abid K, Zafar MS. Literature search strategies in dental education and research. J Taibah Univ Med Sci 2021; 16 (06) 799-806
    PubMedGoogle Scholar
  • 26 Chour VG, Chour GR, Deep S, Rajwadha N, Agrawal A, Sodhi A. Nasoalveolar Molding Prior to the Closure of Lip in Cleft Lip and Palate: A Clinical Study. Baba Farid University Dental Journal 2019; 9 (02) 8-13
    Google Scholar
  • 27 Doifode D, Ninawe N, Khandelwal V, Bahadure R, Nagpal D, Chouhan SP. Nasoalveolar Molding in Infant with Cleft Lip and Cleft Palate. Int J Prev Clin Dent Res 2018; 5 (01) 87-90
    CrossrefGoogle Scholar
  • 28 Subramanian CS, Prasad NKKK, Chitharanjan AB, Liou EJW. A modified presurgical orthopedic (nasoalveolar molding) device in the treatment of unilateral cleft lip and palate. Eur J Dent 2016; 10 (03) 435-438 DOI: 10.4103/1305-7456.184146.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Kapadia H, Olson D, Tse R, Susarla SM. Nasoalveolar molding for unilateral and bilateral cleft lip repair. Oral Maxillofac Surg Clin North Am 2020; 32 (02) 197-204
    CrossrefPubMedGoogle Scholar
  • 30 Gong X, Dang R, Xu T, Yu Q, Zheng J. Full digital workflow of nasoalveolar molding treatment in infants with cleft lip and palate. J Craniofac Surg 2020; 31 (02) 367-371
    CrossrefPubMedGoogle Scholar
  • 31 Alfonso AR, Ramly EP, Kantar RS. et al. What is the burden of care of nasoalveolar molding?. Cleft Palate Craniofac J 2020; 57 (09) 1078-1092
    CrossrefPubMedGoogle Scholar
  • 32 Oliveira NV, Tou GAA, Silva RS, Rezende SE, Pretti H, Macari S. The first-year follow-up of a cleft lip and palate patient treated with nasoalveolar molding (NAM). Braz Dent J 2020; 31 (02) 190-196
    CrossrefPubMedGoogle Scholar
  • 33 Steven L. Goudy TTT. Complete Cleft Care: Cleft and Velopharyngeal Insuffiency Treatment in Children. 1st ed.. Stuttgart: Thieme; 2015
    Google Scholar