A Comparative Cephalometric Study of Nasoalveolar Molding– and Non-Nasoalveolar Molding–Treated Bilateral Cleft Patients at Early Mixed Dentition Period

Abstract

Objective: To evaluate and compare early maxillary growth in 2 groups of patients with repaired bilateral cleft lip and palate (BCLP) who had and had not received nasoalveolar molding (NAM) therapy in infancy. Hypothesis: Nasoalveolar molding does not have any effect on maxillomandibular growth at the early mixed dentition period. Design: Retrospective study. Patients: The study group consisted of forty-two 7-year-old patients with BCLP—20 in the NAM group and 22 in the no-NAM group. The control group consisted of nineteen 7-year-old noncleft, normal patients. Interventions: Nasoalveolar molding was carried out prior to surgeries in those children who were brought in within 8 weeks of birth. Children brought in later were treated without a presurgical intervention. All patients were treated with a single-stage modified Millard cheiloplasty without gingivoperiosteoplasty. Palatoplasty was done by single-stage Bardach palatoplasty with muscle repositioning. Mean Outcome Measures: Hard tissue and dental cephalometric values measured on lateral cephalograms, recorded at 7 years of age. Results: A comparison of the mean sagittal values showed a statistically significant maxillomandibular retrusion and incisor retroclination of both BCLP groups in comparison to the control group. None of the cephalometric parameters varied statistically between NAM and no-NAM groups. The maxillomandibular relation, lower face height ratio, mandibular plane, and mandibular axis angles did not show statistically significant difference between all 3 groups. Conclusions: On the basis of this study, NAM does not have any effect on maxillomandibular growth at the early mixed dentition period.