Objectives: The purpose of this study was to evaluate the short-term effect of series of preadjusted vacuum formed nasoalveolar molding VF NAM aligners on the morphology of nose, lip, and maxillary arch in infants with unilateral cleft lip and palate (UCLP). Design: Prospective clinical trial. Setting: Unilateral cleft lip and palate patients referred to outpatients’ clinic. Patients: Sixteen nonsyndromic infants with UCLP, less than 2 months of age were included from April 2017 to April 2018. Interventions: All infants received VF NAM therapy. Standardized digital frontal and basilar photographs and 3D digital models were taken before initiation of VF NAM therapy (T1) and after completion of VF NAM therapy (T2). Main Outcome Measure(s): Changes in morphology of the nose, lip, and maxillary arch. Results: Statistical analysis comparing T1 and T2 measurements was performed. Frontal and basilar photographic analysis showed a statistically significant reduction of columella displacement, interlabial gap distance, and nostril width at cleft side (CS), while the nasal height, nostril height at CS, nostril width at noncleft side (NCS), columella deviation angle, nasal tip protrusion, and nostril area at both CS and NCS increased significantly with VF NAM therapy. The nasal width, nostril height at NCS showed no significant change after presurgical VF NAM aligners therapy. The analysis of digital models demonstrated a statistically significant reduction of alveolar cleft width, anterior arch width, arch length, midline deviation, and palatal cleft width, while the posterior arch width and arch perimeter increased significantly with VF NAM therapy. Conclusion: Vacuum formed NAM therapy was effective in reducing the nasoalveolar deformities associated with infants with UCLP and improved the alveolar morphology and nasal symmetry.

Aim. The aim of this study was to compare the chairside time, bond failure rate, and accuracy of bonding between two orthodontic attachment indirect bonding techniques. Methods and Materials. Two indirect bonding techniques were studied: unaltered base attachment (UA) and custom base attachment (CBA) methods. Eighty-four orthodontic attachments were bonded on six patient stone models. Preoperative models were digitally scanned, and subsequently, attachments were transferred with the aid of a single but sectioned vacuum-formed tray to their corresponding patients. Finally, participants were scanned after attachment bonding to make the postoperative digital replicas. Chairside time and immediate bond failure rates were measured and compared between both techniques. Postoperative and preoperative digital models were then superimposed in order to measure the accuracy of bonding in the three dimensions of space. Results. No differences existed between the two techniques regarding chairside time ( P = 0.87 ) and bond failure rates ( P = 0.37 ). There were also no differences found for the total attachment movement ( P = 0.73 ), mesiodistal ( P = 0.10 ), occlusogingival ( P = 0.31 ), torquing ( P = 0.21 ), and rotational measurements ( P = 0.18 ). The UA technique, however, proved to be more accurate for buccopalatal linear directions ( P = 0.04 ), whilst the CBA technique showed more accuracy for tipping angular deviations ( P < 0.01 ). There was a statistically significant directional bias for the UA towards the occlusal ( P < 0.01 ) and palatal ( P = 0.02 ) directions with mesial-out angular deviation ( P = 0.02 ). Conclusion. The two indirect bonding techniques were comparable for chairside time, bond failure rates, and most linear and angular measurements. The UA technique was, however, superior in buccopalatal directions, while the CBA method showed more tipping accuracy. Both techniques were efficient and reliable for indirect bonding.