A Comprehensive Clinical Perspective of Nasoalveolar Molding (NAM) for the Treatment of Cleft Lip and Palate patients

鼻牙槽成形术(NAM)治疗唇腭裂患者的综合临床视角

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Abstract

BACKGROUND: Cleft lip and palate is widespread congenital abnormalities affecting the orofacial area. Nasoalveolar Molding (NAM) is a pre-surgical orthodontic method that has revolutionized the management of newborns with cleft lip and palate. Objectives: The purpose of this research are to present the steps of NAM appliance construction as well as to evaluate how presurgical nasoalveolar molding affected the long-term nasal, alveolar, and palate shape of infants with cleft lip and palate. MATERIAL AND METHODS: Individuals with complete unilateral cleft lip and palate are candidates for NAM treatment. Earlier intervention, within the initial weeks of life, is essential for attaining best outcomes. Patients must be assessed for their general health and appropriateness for the NAM management. RESULTS: The improvement of nostril height was 0.8 mm after application of NAM appliance and after primary surgical repair by 0.7mm, whereas the nostril width reported decrease by 1.4 mm after utilization of NAM and by 1 mm after lip repair. Columella-nasal base angle increase from 51.8 º to 90.1 º after application of NAM appliance and primary surgical repair. There were reduction of alveolar gap width by 7.6 mm and 9.3 mm after application of NAM appliance and primary surgical repair respectively. CONCLUSIONS: Nasoalveolar molding is effective pre-operative treatment for newborns with cleft lip and palate in comparison to their birth status. The advantages of this advanced approach to cleft treatment will be further increased by continuous research and improvement of NAM procedures, as well as a strong focus on interdisciplinary collaboration. Key words:Nasoalveolar molding for cleft lip and palate, Craniofacial anomalies, Pediatric dentistry, Infant Orthopedics, Pre-surgical orthodontics, Quality of life.

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