Function of Nasoalveolar Molding Devices in Bilateral Complete Cleft Lip and Palate: A 3-Dimensional Maxillary Arch Analysis.

OBJECTIVE: This study aimed to observe and analyze the effects of nasoalveolar molding (NAM) on maxillary arch dimensions in patients with bilateral complete cleft lip and palate (BCLP) using 3-dimensional analyses. DESIGN: Retrospective case series. MATERIALS AND METHODS: Seventeen infants were treated using modified Khon Kaen University presurgical nasoalveolar molding devices (KKU-NAM). Dental casts were evaluated 3 dimensionally at 3 time points: pretreatment (T1), after using modified KKU-NAM for 2 weeks (T2), and before cheiloplasty (T3). Repeated-measures analysis of variance and Friedman test were used to compare the maxillary arch dimensions between time points. RESULTS: Both sides of the cleft width, premaxilla deviation, and premaxilla protrusion had significantly reduced with the use of KKU-NAM. Premaxillary rotation had significantly improved, whereas the arch depth did not change significantly. Premaxilla width, posterior arch width, alveolar length, and height had significantly increased. The anterior arch width, intercanine width, and lateral sulcus width showed no significant changes. The intraclass correlation coefficient used to test the measurements indicated substantial reliability. CONCLUSION: The modified KKU-NAM is an effective device for reducing the severity of bilateral cleft deformities, especially in the premaxilla area.

Evaluation of Postorthodontic Changes in the Treatment of Cleft Lip and Palate Patients Using the PAR Index.

OBJECTIVE: To evaluate dental changes in cleft patients after undergoing orthodontic treatment for at least 2 years. HYPOTHESIS: The dental change would decline significantly after 2 years of completing orthodontic treatment. DESIGN: This is a retrospective study. PATIENT: Eighteen repaired cleft lip and palate patients from the Faculty of Dentistry, KhonKaen University, Thailand, participated in this study. MEAN OUTCOME MEASURES: A dental model with before treatment (T0), completed treatment (T1), and retention period (T2) data was analyzed using the peer assessment rating (PAR) index. RESULT: The results showed that the PAR score improved enormously after treatment; from T0 to T1, it was 34.00 ± 10.01 to 4.67 ± 2.47, and there was a reversion in the retention period. There was statistical significance between T0, T1, and T2, with P values <.001, .005, and <.001 when comparing T0 with T1, T1 with T2, and T0 with T2, respectively. CONCLUSION: Occlusion in cleft lip and palate patients changed from the time of completing treatment to the final results after the retention period. To sustain satisfactory results, orthodontists should plan carefully for the retention period before performing the treatment.