The purpose of this article was to present a modified protocol and devices of presurgical nasoalveolar molding techniques to improve deformity of lip, nose and alveolus at department of orthodontic, khon kaen university kku. Despite the growing debate about the efficacy of nasoalveolar molding, questions remain regarding its prevalence and the demographic characteristics of families undergoing this technique prior to. Presurgical nasoalveolar molding pnam was introduced to reshape the alveolar and nasal segments prior to surgical repair. Nam therapy has demonstrated to be an effective method for reducing cleft and improve nose anatomy. Newborn babies born with a cleft lip and cleft palate can undergo nasoalveolar molding nam, a nonsurgical method of reshaping the gums, lip and nostrils before cleft lip and cleft palate surgery. Nam therapy as part of the treatment protocol for infants born with cleft lip and palate. Treating cleft palate with presurgical nasoalveolar. Listing a study does not mean it has been evaluated. Cleft lip and palate constitutes one of the most common congenital anomalies. Presurgical nasoalveolar molding pnam is a nonsurgical method of reshaping the gums, lips and nostrils previous to clp surgery, thus lessening the severity of the cleft. Presurgical nasoalveolar molding technique there are numerous claims that treatment of cleft lip and palate during neonatal life needs presurgical orthopedic treatment and surgical correction of clefts. Early progressive maxillary changes with nasoalveolar molding. The progressive changes of nasal symmetry and growth after nasoalveolar molding.
A 5mm diameter hole is made in the centre of the acrylic. Nam was developed not only to correct deviated alveolar segments but. Effects of nasoalveolar molding therapy on alveolar morphology in unilateral cleft lip and palate using two different approaches puneet batra 1, mv ashith 2, shaksham mittal 1, akhter hussain 2, khader mustafa 2, sudeshwar sood 3 1 department of orthodontics and dentofacial orthopedics, institute of dental studies and technologies, meerut, uttar pradesh, india 2 center for craniofacial surgery. Setting and sample population this is a retrospective case series study. Nasoalveolar molding nam is commonly employed to reduce the alveolar segments into proper alignment and to improve nasal symmetry in patients. Nasoalveolar molding represents a paradigm shift from the traditional methods of presurgical infant orthopedics. Presurgical nasoalveolar molding for correction of cleft. These new techniques greatly improve upon the results usually achieved through traditional cleft palate appliances. The indian dental academy is the leader in continuing dental education, training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Iino mitsuyoshi et al 2004 reported a new preoperative nasoalveolar molding for infants with unilateral cleft lip and palate.
Cleft lip and cleft palate are among the most common birth defects. Comparison of two nasoalveolar molding techniques in. Nasoalveolar molding in cleft careexperience in 40. Orthopaedic traction with passive nasoalveolar moulding in a bilateral cleft lip and palate patient rediscovering the old.
Standardized parameters of cleft width and nasal symmetry were measured. Presurgical nasoalveolar molding in a 4dayold infant with. Nasoalveolar molding for infants born with clefts of the. This two day intensive workshop focuses on developing the skills and knowledge necessary to provide care for children born with cleft lip and palate. Effects of nasoalveolar molding therapy on alveolar. This presurgical management of the infants cleft is intended to reduce severity of the oronasal mouth and nose deformity prior to. Presurgical nasoalveolar molding pnam represents a paradigm shift from the traditional methods of presurgical infant orthopedics. It is possible to incorporate presurgical nam at centers where basic plastic surgery services and support of. Presurgical nasoalveolar molding in a 4dayold infant with unilateral cleft lip, alveolus, and palate deformity. Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. To assess nostril symmetry and alveolar cleft width in infants with unilateral cleft lip and palate following presurgical nasoalveolar molding. Nasoalveolar moulding for cleft lip and palate free download as powerpoint presentation.
Nasoalveolar molding nam is a treatment option available for early cleft care. Symmetry of the nose after presurgical nasoalveolar molding in. American journal of orthodontics and dentofacial orthopedics. Effects of nasoalveolar molding therapy on nasal and.
Cleft lip and palate informationnasoalveolar moulding nasoalveolar moulding nam your plastic surgeon may refer you to see a specialist dentist or orthodontist for nasoalveolar moulding. Nam is an adjunctive treatment to aid primary surgical reconstruction. Grayson has been conducting a twice annual, two day hands on workshop on nasoalveolar molding. Presurgical nasoalveolar molding may be successfully employed in the early management of both the unilateral and bilateral cleft anomalies in newborns. A presurgical nasoalveolar moulding pnam procedure was planned to facilitate an. The penam device was supported by an adhesivetaped upper lip, which consisted of a lip nasal stent made from a 0. Barry grayson today at 12122635204 or visit our office servicing new york, ny.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Nasoalveolar molding nam has gained wide acceptance and evidence in cleft therapy. Nasoalveolar molding can be useful adjunct for treatment of cleft lip nasal deformity. One of the problems that the traditional approach failed to address was the deformity of the nasal cartilages in unilateral, as well as bilateral, clefts of the lip and palate and the deficiency of columella tissue in infants with. Methods on the initial visit, lip taping using 14inch 3m steristrip was applied and. A cleft lip picture 1 is the result of the lip not fusing joining together. This new protocol was developed in order to address nasal problems as early as possible with a new extraoral type of nasal. Presurgical nasoalveolar molding sunrise orthodontics. Nasoalveolar moulding orthodontic courses by indian dental academy free download as powerpoint presentation. Clinical application of customized presurgical nasoalveolar molding. The shape of the cartilaginous septum, alar cartilage tip, medial. A 3d prospective analysis pang yun chou 1,2, rami r.
Presurgical naso alveolar molding free download as powerpoint presentation. Despite the growing debate about the efficacy of nasoalveolar molding, questions remain regarding its pr. Nasoalveolar molding treatment protocol in patients with. An extraoral nasoalveolar molding technique in complete. However, standardized treatment protocols and experiences recorded from european centres are lacking.
The morphological changes achieved with nam therapy occur in early treatment phase. Furthermore, the paper highlights the advantages of nam therapy along. Childrens hospital of philadelphia chop is one of the few places in the country to offer nasoalveolar molding nam, a presurgical treatment that improves outcomes for children with cleft lip. Influence of nasoalveolar molding on skeletal development. The results of 40 infants with cleft lip and palate treated with presurgical nam according to the grayson technique were analyzed. Pdf cleft lip and palate constitutes one of the most common congenital anomalies hibbert and field, 1996. Nasoalveolar molding nam for cleft lip and palate 3 of. In the control group no nasoalveolar molding, the mean of the volumes measured after birth was 1050. The nasoalveolar molding nam technique we describe uses acrylic nasal stents attached to the vestibular shield of an oral molding plate to mold the nasal alar cartilages into normal form and position during the neonatal period. Presurgical infant orthopedics has been employed since 1950 as an adjunctive neonatal therapy for the correction of cleft lip and palate.
Presurgical nasoalveolar molding in a 4dayold infant. Presurgical nasoalveolar molding pnam for a unilateral. Introduction a four day old male infant was referred to our department. Laxmikanth, trupti karagi, anjana shetty, sushruth shetty department of orthodontics and dentofacial orthopaedics, aecs maaruti college of dental sciences and research centre, bengaluru, karnataka, india abstract cleft lip and palate clp is the most common congenital defect of the oral cavity. Nasoalveolar moulding orthodontic courses by indian. Hallac 1,3, tochi ajiwe 1, xian jin xie 4, y ufang liao 5, alex a. About 4mm to 7mm lengthening of collumela can be achieved by this procedure. Most of these therapies did not address deformity of the nasal cartilage in unilateral and bilateral cleft lip and palate as well as the deficiency of the columella tissue in infants with bilateral cleft. Influence of nasoalveolar molding on skeletal development in patients with unilateral cleft lip and palate at 5 years of age.
Threedimensional evaluation of the effect of nasoalveolar. Effect of novel nasoalveolar molding techniques on parents. Pour impression, with care that cleft area and frenum attachments are included. An initial nasoalveolar molding appliance was created based on the patients first and only inperson maxillary cast, produced from a traditional intraoral dental impression. All of the images on this website are ed and are offered to the public for information purposes only. Presurgical nasoalveolar molding in infants with cleft lip and palate. Nasoalveolar molding nam gallery earwell center of. Nasoalveolar molding without collumelar lengthening may require surgical correction.
T2 after nasoalveolar molding participants nasoalveolar molding will be finished before surgery, an expected average of 3months old nostril height. Before the introduction of the concept of nam, repair of a huge cleft involved several surgeries between birth and 18 years of age, setting the child at risk for emotional. Pnam pre naso alveolar molding linkedin slideshare. Nasoalveolar molding nam unilateral cleft lip and palate. Article information, pdf download for early progressive maxillary.
A 12dayold boy presented with complete unilateral cleft lip and palate. Orthopaedic traction with passive nasoalveolar moulding in a. On clinical examination patient showed complete unilateral cleft lip, alveolus and palate deformity towards the left side. Introductionnasoalveolar molding nam is a treatment option available for early cleft care. Effect of novel nasoalveolar molding techniques on parents satisfaction and short term treatment outcomes in unilateral cleft lip and palate infants. Thereafter, each patients molding course was simulated using computer software that aimed to narrow the alveolar gap by 1 mm each week by rotating the greater alveolar segment. Nasoalveolar molding use for cleft lip, palate reduces the. This paper presents a case report of three cleft lip and palate individuals treated with nam therapy. Nasoalveolar medical definition merriamwebster medical. Nasoalveolar pronounced nayzohalveeuhler molding nam is a nonsurgical way to reshape the gums, lip and nostrils with a plastic plate before cleft lip and palate surgery. Nasoalveolar molding nam bilateral left lip and palate.
Infants mother complained of an opening over lip and difficulty in feeding and desires to get it corrected. Nam uses an orthodontic appliance to mould and reposition the segments of the cleft gum pads, lips and nostrils into a more favourable position to. Its purpose is to bring everything as close together as possible prior to surgery, as well as help shape the nose and increase the columella which is the piece of skin between your nostrils. Nasoalveolar moulding for cleft lip and palate medical. On stone model, block undercuts of cleft area with wonderfill or wax to allow for fabrication of maxillary plate. Case report presurgical nasoalveolar molding techniques. Over the time there have been changes in the concepts of the same. The nasoalveolar molding device nam can be used for both bilateral and unilateral cleft lip babies. Presurgical nasoalveolar molding for cleft lip and palate. This happens during the first few months of a babys development in the womb.
This video describes nasoalveolar molding nam therapy, a treatment offered by orthodontists at seattle childrens hospital for infants with cleft lip. Nasoalveolar molding can be a useful, costeffective adjunct for treatment of cleft lip nasal deformity. In the nasoalveolar molding group, the mean of the volumes measured after birth was 703. During the first three months of life the surgical treatment of clp usually involves infant orthopaedics, such as presurgical nasoalveolar molding. In addition, the aim was to decrease the width of the alar base of the affected side and approximate the lip segments by placing an adhesive tape across the upper lip segments.
1095 1264 996 530 1164 85 570 450 1173 906 351 1030 324 688 1410 1346 1606 972 790 190 778 97 383 712 1123 1522 121 1287 871 12 1450 597 460 1487 687 370 1238 652 469 173 1155 200 1119 1453 1108 569