Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제47권4호
  • /
  • Pages.257-268
  • /
  • 2021
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Comparative evaluation of nasal and alveolar changes in complete unilateral cleft lip and palate patients using intraoral and extraoral nasoalveolar molding techniques: randomized controlled trial

  • Kalaskar, Ritesh (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital) ;
  • Bhaje, Priyanka (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital) ;
  • Sharma, Priyanka (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital) ;
  • Balasubramanian, Shruti (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital) ;
  • Ninawe, Nupur (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital) ;
  • Ijalkar, Rajesh (Department of Pediatric and Preventive Dentistry, Government Dental College & Hospital)
  • 투고 : 2020.12.26
  • 심사 : 2021.03.04
  • 발행 : 2021.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: Cleft lip and palate is a common congenital anomaly that impairs the aesthetics, speech, hearing, and psychological and social life of an individual. To achieve good aesthetic outcomes, presurgical nasoalveolar molding (NAM) has become important. Currently, the intraoral NAM technique is widely practiced. Numerous modifications have been made to intraoral NAM techniques, but the original problem of compliance leading to discontinuation of treatment remains unsolved. Therefore, the present study compared an extraoral NAM technique with the intraoral NAM technique. Materials and Methods: Twenty infants with complete unilateral cleft lip and palate were included and divided into two equal groups. Group A received the intraoral NAM technique, and Group B received the extraoral NAM technique. Pre- and postoperative extraoral and intraoral measurements were recorded. Results: Groups A and B did not differ significantly in any extraoral or intraoral parameter. Conclusion: The extraoral NAM technique is as effective as the intraoral NAM technique in achieving significant nasal and alveolar changes in complete unilateral cleft lip and palate patients. Additionally, it reduces the need for frequent hospital visits for activation and the stress associated with the insertion and removal of the intraoral NAM plate, thereby improving compliance.

키워드

과제정보

We wish to thank all the parents who consented and agreed for the publication of data.

참고문헌

  1. Grayson BH, Garfinkle JS. Early cleft management: the case for nasoalveolar molding. Am J Orthod Dentofacial Orthop 2014;145:134-42. https://doi.org/10.1016/j.ajodo.2013.11.011
  2. Mossey PA, Shaw WC, Munger RG, Murray JC, Murthy J, Little J. Global oral health inequalities: challenges in the prevention and management of orofacial clefts and potential solutions. Adv Dent Res 2011;23:247-58. https://doi.org/10.1177/0022034511402083
  3. Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet 2009;374:1773-85. https://doi.org/10.1016/S0140-6736(09)60695-4
  4. Dixon MJ, Marazita ML, Beaty TH, Murray JC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet 2011;12:167-78. https://doi.org/10.1038/nrg2933
  5. Mossey PA, Little J. Epidemiology of oral clefts: an international perspective. In: Wyskynski DF, ed. Cleft lip and palate: from origin to treatment. Oxford: Oxford University Press; 2002:127-58.
  6. Berkowitz S. Cleft lip and palate: diagnosis and management. 3rd ed. Berlin: Springer; 2013.
  7. Wong FW, King NM. The oral health of children with clefts--a review. Cleft Palate Craniofac J 1998;35:248-54. https://doi.org/10.1597/1545-1569_1998_035_0248_tohocw_2.3.co_2
  8. Hunt O, Burden D, Hepper P, Johnston C. The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthod 2005;27:274-85. https://doi.org/10.1093/ejo/cji004
  9. Pfeifer TM, Grayson BH, Cutting CB. Nasoalveolar molding and gingivoperiosteoplasty versus alveolar bone graft: an outcome analysis of costs in the treatment of unilateral cleft alveolus. Cleft Palate Craniofac J 2002;39:26-9. https://doi.org/10.1597/1545-1569_2002_039_0026_nmagva_2.0.co_2
  10. Grayson BH, Santiago PE, Brecht LE, Cutting CB. Presurgical nasoalveolar molding in infants with cleft lip and palate. Cleft Palate Craniofac J 1999;36:486-98. https://doi.org/10.1597/1545-1569_1999_036_0486_pnmiiw_2.3.co_2
  11. Figueroa AA, Polley JW. Orthodontics in cleft lip and palate management. In: Mathes SJ, ed. Plastic surgery: pediatric plastic surgery. 2nd ed. Philadelphia: Saunders; 2006:271-310.
  12. Liou EJ, Subramanian M, Chen PK, Huang CS. The progressive changes of nasal symmetry and growth after nasoalveolar molding: a three-year follow-up study. Plast Reconstr Surg 2004;114:858-64. https://doi.org/10.1097/01.prs.0000133027.04252.7a
  13. Matsuo K, Hirose T, Tomono T, Iwasawa M, Katohda S, Takahashi N, et al. Nonsurgical correction of congenital auricular deformities in the early neonate: a preliminary report. Plast Reconstr Surg 1984;73:38-51. https://doi.org/10.1097/00006534-198401000-00009
  14. Liao YF, Hsieh YJ, Chen IJ, Ko WC, Chen PK. Comparative outcomes of two nasoalveolar molding techniques for unilateral cleft nose deformity. Plast Reconstr Surg 2012;130:1289-95. https://doi.org/10.1097/PRS.0b013e31826d16f3
  15. Sischo L, Clouston SA, Phillips C, Broder HL. Caregiver responses to early cleft palate care: a mixed method approach. Health Psychol 2016;35:474-82. https://doi.org/10.1037/hea0000262
  16. Wang Q, Zhou L, Zhao JZ, Ko EW. An extraoral nasoalveolar molding technique in complete unilateral cleft lip and palate. Plast Reconstr Surg Glob Open 2013;1:e26. https://doi.org/10.1097/GOX.0b013e31829e0d4b
  17. Koya S, Husain A, Khader M. Complete bilateral cleft lip and palate with protruding premaxilla: a multidisciplinary approach. Arch Med Health Sci 2018;6:298-9. https://doi.org/10.4103/amhs.amhs_136_18
  18. Murthy PS, Deshmukh S, Bhagyalakshmi A, Srilatha K. Pre surgical nasoalveolar molding: changing paradigms in early cleft lip and palate rehabilitation. J Int Oral Health 2013;5:70-80.
  19. Yang S, Stelnicki EJ, Lee MN. Use of nasoalveolar molding appliance to direct growth in newborn patient with complete unilateral cleft lip and palate. Pediatr Dent 2003;25:253-6.
  20. Grayson BH, Maull D. Nasoalveolar molding for infants born with clefts of the lip, alveolus, and palate. Semin Plast Surg 2005;19:294-301. https://doi.org/10.1055/s-2005-925902
  21. McNeil CK. Orthodontic procedures in the treatment of congenital cleft palate. Dent Rec (London) 1950;70:126-32.
  22. Dogliotti PL, Bennun RD, Losoviz EA, Ganiewich E. [Non-surgical treatment of nasal deformity in the cleft patient]. Rev. Ateneo Argent Odontol 1991;27:31-5. Spanish.
  23. Chen YF, Liao YF. A modified nasoalveolar molding technique for correction of unilateral cleft nose deformity. J Craniomaxillofac Surg 2015;43:2100-5. https://doi.org/10.1016/j.jcms.2015.10.003
  24. Shetty V, Vyas HJ, Sharma SM, Sailer HF. A comparison of results using nasoalveolar moulding in cleft infants treated within 1 month of life versus those treated after this period: development of a new protocol. Int J Oral Maxillofac Surg 2012;41:28-36. https://doi.org/10.1016/j.ijom.2011.09.002
  25. Shapira Y, Lubit E, Kuftinec MM, Borell G. The distribution of clefts of the primary and secondary palates by sex, type, and location. Angle Orthod 1999;69:523-8. https://doi.org/10.1043/0003-3219(1999)069<0523:TDOCOT>2.3.CO;2
  26. Tabaie S. Stopping female feticide in India: the failure and unintended consequence of ultrasound restriction. J Glob Health 2017;7:010304. https://doi.org/10.7189/jogh.07.010304
  27. Jurkiewicz MJ, Bryant DL. Cleft lip and palate in dogs: a progress report. Cleft Palate J 1968;5:30-6.
  28. Monasterio L, Ford A, Gutierrez C, Tastets ME, Garcia J. Comparative study of nasoalveolar molding methods: nasal elevator plus DynaCleft® versus NAM-Grayson in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 2013;50:548-54. https://doi.org/10.1597/11-245
  29. Zuhaib M, Bonanthaya K, Parmar R, Shetty PN, Sharma P. Presurgical nasoalveolar moulding in unilateral cleft lip and palate. Indian J Plast Surg 2016;49:42-52. https://doi.org/10.4103/0970-0358.182235
  30. Gomez DF, Donohue ST, Figueroa AA, Polley JW. Nasal changes after presurgical nasoalveolar molding (PNAM) in the unilateral cleft lip nose. Cleft Palate Craniofac J 2012;49:689-700. https://doi.org/10.1597/11-007
  31. Pai BC, Ko EW, Huang CS, Liou EJ. Symmetry of the nose after presurgical nasoalveolar molding in infants with unilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J 2005;42:658-63. https://doi.org/10.1597/04-126.1
  32. Singh GD, Levy-Bercowski D, Santiago PE. Three-dimensional nasal changes following nasoalveolar molding in patients with unilateral cleft lip and palate: geometric morphometrics. Cleft Palate Craniofac J 2005;42:403-9. https://doi.org/10.1597/04-063.1
  33. Patel D, Goyal R. Pre-surgical nasoalveolar moulding in patient with unilateral cleft of lip, alveolus and palate: case report. J Plast Reconstr Aesthet Surg 2012;65:122-6. https://doi.org/10.1016/j.bjps.2011.06.011
  34. Prahl C, Kuijpers-Jagtman AM, van't Hof MA, Prahl-Andersen B. A randomised prospective clinical trial into the effect of infant orthopaedics on maxillary arch dimensions in unilateral cleft lip and palate (Dutchcleft). Eur J Oral Sci 2001;109:297-305. https://doi.org/10.1034/j.1600-0722.2001.00056.x
  35. Mishima K, Mori Y, Sugahara T, Minami K, Sakuda M. Comparison between palatal configurations in UCLP infants with and without a Hotz plate until four years of age. Cleft Palate Craniofac J 2000;37:185-90. https://doi.org/10.1597/1545-1569_2000_037_0185_cbpciu_2.3.co_2
  36. Sabarinath VP, Thombare P, Hazarey PV, Radhakrishnan V, Agrekar S. Changes in maxillary alveolar morphology with nasoalveolar molding. J Clin Pediatr Dent 2010;35:207-12. https://doi.org/10.17796/jcpd.35.2.f80u21362566qr34
  37. Doruk C, Kilic B. Extraoral nasal molding in a newborn with unilateral cleft lip and palate: a case report. Cleft Palate Craniofac J 2005;42:699-702. https://doi.org/10.1597/04-134r.1
  38. Larson M, Sallstrom KO, Larson O, McWilliam J, Ideberg M. Morphologic effect of preoperative maxillofacial orthopedics (T-traction) on the maxilla in unilateral cleft lip and palate patients. Cleft Palate Craniofac J 1993;30:29-34. https://doi.org/10.1597/1545-1569_1993_030_0029_meopmo_2.3.co_2
  39. Da Silveira AC, Oliveira N, Gonzalez S, Shahani M, Reisberg D, Daw Jr JL, et al. Modified nasal alveolar molding appliance for management of cleft lip defect. J Craniofac Surg 2003;14:700-3. https://doi.org/10.1097/00001665-200309000-00018
  40. Nordin KE, Larson O, Nylen B, Eklund G. Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. I. The method and the skeletal development from seven to thirteen years of age. Scand J Plast Reconstr Surg 1983;17:33-50. https://doi.org/10.3109/02844318309007177