Cleft lip and/or cleft palate (CL±P) in addition to the cleft palate (CP) are a category of anomalies known as orofacial clefts (OC). These anomalies are accompanied by several aesthetic and functional problems. Information on the prevalence of OC showed different values between studies worldwide. In addition, the presence of cleft lip and/or cleft palate is determined by several changes during the embryonic stage. Besides, cleft repair may lead to a significant impact on the overall aesthetic and function and could negatively affect maxillary growth on certain occasions. Therefore, having the background and knowledge on this phenomenon is essential in designing the overall treatment and obtaining outcomes that are as close to normal as possible. This article reviews the maxillary development, occurrence of cleft lip and/or palate and their prevalence, facial growth in the presence of clefts, effect of cleft repair, an overview of alveolar cleft treatment, as well as the essential information related the prevention of cleft lip and palate.
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.
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