Influence of presurgical nasoalveolar molding (PNAM) treatment in maxillary dental arch width and nasolabial symmetry in patients with unilateral complete cleft lip and palate
1Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, 710004 Xi’an, Shaanxi, China
2Department of Orthodontics, College of Stomatology, Xi’an Jiaotong University, 710004 Xi’an, Shaanxi, China
3Department of Cleft Lip and Palate Surgery, College of Stomatology, Xi’an Jiaotong University, 710004 Xi’an, Shaanxi, China
DOI: 10.22514/jocpd.2023.090 Vol.47,Issue 6,November 2023 pp.155-162
Submitted: 07 March 2023 Accepted: 19 May 2023
Published: 03 November 2023
† These authors contributed equally.
Unilateral complete cleft lip and palate (UCCLP) is one of the most severe clinical subphenotypes among nonsyndromic cleft lip and/or palate (NSCL/P), that complicates surgical repair operations. Presurgical nasoalveolar molding (PNAM) is a technique used to reshape the nose, lip and alveolar bone of infants with UCCLP before surgery (the modified Mohler rotation advancement cheiloplasty and two flap palatoplasty), with the potential to facilitate surgical repair. However, the effectiveness of PNAM treatment is still a matter of debate. In this paper, the 3Shape scanning system and 3dMD stereophotography were used to assess the short-term and long-term effects of PNAM treatment on the dental arch morphology and nasolabial features of patients with UCCLP, respectively. The findings indicated that PNAM treatment negatively affects both short-term and long-term dental arch shape compared to the treatment without PNAM, particularly in terms of limiting the transverse width of the maxillary canine-to-midline. Regarding the nasal and labial symmetry, PNAM improves the symmetry of the nasal alae in patients over 7 years old and the symmetry of the lip in patients under 7 years old. Moreover, UCCLP patients who received PNAM treatment exhibited a shorter and wider shape of the nostril on the cleft side compared to those without PNAM treatment. In clinical practice, the multidisciplinary team should carefully consider the advantages and disadvantages of the outcomes of PNAM treatment when treating infants with cleft lip and palate.
Presurgical nasoalveolar molding; Cleft lip and palate; Unilateral complete cleft lip and palate; Dental arch morphology; Nasolabial features
Le Chang,Qianqian Huang,Zhanping Ren,Yanhao Wang,Yuhua Jiao,Yongwei Tao,Huaxiang Zhao,Yuxia Hou. Influence of presurgical nasoalveolar molding (PNAM) treatment in maxillary dental arch width and nasolabial symmetry in patients with unilateral complete cleft lip and palate. Journal of Clinical Pediatric Dentistry. 2023. 47(6);155-162.
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