Retrospective Evaluation of Alveolar and Nasolabial Changes After Nasoalveolar Molding in Patients With Bilateral Cleft Lip and Palate

Objective To evaluate the alveolar and nasolabial changes in infants with complete bilateral cleft lip and palate (CBCLP) with deviated and nondeviated premaxilla following nasoalveolar molding (NAM) and to compare the nasolabial changes induced by NAM with growth changes in healthy infants. Design Retrospective case-control study. Setting Tertiary care was provided at the Department of Orthodontics, Faculty of Dentistry, Yeditepe University. Patients, Participants Seventeen infants with CBCLP and 17 healthy controls were included. The subgroups were created regarding premaxillary deviation. Interventions NAM treatment. Main Outcome Measures Linear and angular measurements were made on 3D images obtained from intraoral plaster models and stereophotogrammetric facial images. Results In patients with CBCLP, alveolar cleft widths and premaxillary protrusion were decreased ( P < .001). In the premaxillary deviation subgroup, the deviation was reduced ( P < .001). The philtrum median height was increased ( P < .01) but remained shorter than normal ( P < .001). The increase in columellar length in the CBCLP group was greater than that of the control group, exceeding the amount expected from natural growth ( P < .05). The nasal tip protrusion was increased in the CBCLP group ( P < .05). Conclusion Following the NAM, cleft widths and lip gaps were reduced, premaxilla was retracted, philtrum median height was increased, and the nasolabial profile was improved in patients with CBCLP. NAM provided alveolar and nasolabial symmetry in the CBCLP group, according to the evaluation of the subgroups. Although the initial nasolabial cleft deformities in patients with CBCLP were improved with NAM, post-NAM nasolabial morphology was still different from that of healthy infants.