Aim: To evaluate the changes in maxillary alveolar morphology in unilateral cleft lip palate infants treated with nasoalveolar molding(NAM). Setting and Design: Study was carried out in the orthodontic department associated with a operating cleft unit in a rural region of central India. Ten UCLP (unilateral cleft lip palate) infants less than 6 weeks of age were treated with NAM prior to surgical repair. Materials and Methods:Pre NAM and Post NAM study models of the UCLP infants were analyzed. Critical linear dimensions including inter- canine width, inter-tuberosity width, arch length and midline deviation were recorded at the different stages using a digital vernier caliper and compared. Statistical analysis were performed using SPSS 13.00 statistical software. Results: Results from this study showed that the width of the alveolar cleft showed a significant decrease with NAM. The arch length and width of the arch in the anterior region also showed a reduction with NAM. The intertuberosity width showed a statistically significant increase during treatment. The arch perimeter showed a significant increase with NAM. Conclusion: NAM was effective in reducing the severity of the initial cleft deformity mainly at the anterior portion of the maxillary arch.

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Background: Various methods have been described for the primary surgical reconstruction of the unilateral cleft lip and palate deformity (UCLP) in infants. There have been several attempts at restoring the normal anatomy of the nose at the time of lip repair in the affected individuals with varying degrees of success. Presurgical nasoalveolar molding (PNAM) is a presurgical infant orthopedic procedure that attempts to target the nasal deformity leading to a more esthetic surgical repair. Objective: At our center we aimed to use PNAM to help in providing the surgical team with a better foundation for an easier and more esthetic single stage repair at the level of nose in addition to the lip and alveolus. Method: The infant nasal cartilages are amenable to correction in the first few weeks of life when they retain their plasticity. Three infants with complete unilateral cleft lip palate (CUCLP) were operated upon after a course of PNAM. No nasal stents were use after repair to retain the results. Results: PNAM reduced the extent of the cleft deformity and improved the anatomic relationship between the affected structures. Postoperative recovery was uneventful. Subjective evaluation immediate post surgery and at the time of palate repair reveals adequate nasolabial esthetics. Long term results of PNAM assisted repair are to be ascertained. Conclusions: The use of PNAM enables in reducing the severity of the deformity the surgical team has to tackle thereby enabling in a better and esthetic primary repair

The cleft alveolus component of the oral cleft deformity is addressed with a separate surgical stage. Several host and operator related factors affect the surgical outcome. When factors that increase the likelihood of secondary alveolar bone graft failure are identified, alterative methods like dentoalveolar distraction (DAD) may be employed. In infants, molding of the alveolar segments is possible and when a synergistic surgical approach is used, the possibility of successful alveolar cleft repair is increased. The authors present two case reports wherein the use of nasoalveolar molding (NAM) and DAD helped to tackle the alveolar cleft deformity.