Effectivness of Pre-surgical Nasoalveolar Molding in Infants with Cleft Lip and Palate
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Abstract
Objective: To assess the effectiveness of pre-surgical nasoalveolar molding (PNAM) in infants with unilateral cleft lip and palate.
Materials and Methods: This Quasi experimental study included 30 infants with unilateral cleft lip and palate having cleft gaps greater than 10 mm, aged below 3 months. Bilateral clefts, syndromic cases, and systemically ill or malnourished infants were excluded. PNAM appliances were fabricated using dental impressions and adjusted weekly over a 3 to 4-month period. Measurements of the inter-alveolar gap, maxillary alveolar cleft length, and palatal gap were taken before and after treatment using Care Stream 3600 intraoral scanning and Microsoft 3D Viewer software. Paired t-tests were used to compare pre- and post-treatment measurements.
Results: Of the 30 infants, 46.7% were below 1 month, 33.3% below 2 months, and 20.0% below 3 months; 66.7% were male. Significant reductions were observed post-treatment: inter-alveolar gap decreased from 12.58 ± 1.40 mm to 2.31 ± 0.92 mm, maxillary alveolar cleft length from 6.17 ± 1.21 mm to 3.52 ± 2.74 mm, and palatal gap from 13.99 ± 2.03 mm to 7.99 ± 2.03 mm (all p < 0.001).
Conclusion: This study shows that PNAM is associated with a reduction in cleft size in infants with unilateral cleft lip and palate. The greatest improvements were seen in infants who began treatment before one month of age.
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