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Is presurgical nasoalveolar molding therapy more effective in unilateral or bilateral cleft lip-cleft palate patients?
Plast Reconstr Surg 2011; 127(3):1263-9PR

Abstract

BACKGROUND

The purpose of this study was to compare the efficacy of presurgical nasoalveolar molding in treating unilateral versus bilateral cleft lip–cleft palate patients.

METHODS

A blinded, retrospective study was conducted with 16 unilateral and 13 bilateral cleft lip–cleft palate patients. Pretreatment and posttreatment facial and intraoral impressions were used to compare soft- and hard-tissue changes.

RESULTS

Nasoalveolar molding therapy improves nasal angle in unilateral (p = 0.010) and bilateral cleft lip–cleft palate (p = 0.001) patients, and improves nostril width in unilateral (p = 0.005) and bilateral cleft lip–cleft palate (p = 0.028) patients. Treatment significantly improves nostril breadth only in unilateral cleft lip–cleft palate patients (p = 0.005). Compared with bilateral cleft lip–cleft palate patients, unilaterally affected patients were more asymmetric before and after nasoalveolar molding therapy. Nasoalveolar molding more effectively increases columellar height (p = 0.002) and columellar width (p = 0.002) in the bilateral cleft lip–cleft palate group. Although starting bialar widths did not significantly differ between the two groups, nasoalveolar molding significantly decreased bialar width only in unilateral cleft lip–cleft palate patients (p = 0.032). When the intersegment alveolar cleft distances of the bilateral cleft lip–cleft palate patients were summed, an improvement similar to that in unilateral cleft lip–cleft palate patients was observed. Furthermore, nasoalveolar molding appeared to prevent alveolar width widening as patients continued to grow.

CONCLUSIONS

There are differences in efficacy between unilateral and bilateral cleft lip–cleft palate patients undergoing nasoalveolar molding. Understanding these differences may help physicians and dentists better shape expectations.

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    Authors+Show Affiliations

    Nazarian Mobin SS
    Children's Hospital Los Angeles, Los Angeles, Calif., USA. snazarian@surgery.usc.edu
    Karatsonyi A
    No affiliation info available
    Vidar EN
    No affiliation info available
    Gamer S
    No affiliation info available
    Groper J
    No affiliation info available
    Hammoudeh JA
    No affiliation info available
    Urata MM
    No affiliation info available

    MeSH

    Alveolar ProcessCleft LipCleft PalateFollow-Up StudiesHumansInfantInfant, NewbornNoseOrthodontics, CorrectivePreoperative CareRetrospective StudiesTreatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    21088643

    Citation

    Nazarian Mobin, Sheila S., et al. "Is Presurgical Nasoalveolar Molding Therapy More Effective in Unilateral or Bilateral Cleft Lip-cleft Palate Patients?" Plastic and Reconstructive Surgery, vol. 127, no. 3, 2011, pp. 1263-9.
    Nazarian Mobin SS, Karatsonyi A, Vidar EN, et al. Is presurgical nasoalveolar molding therapy more effective in unilateral or bilateral cleft lip-cleft palate patients? Plast Reconstr Surg. 2011;127(3):1263-9.
    Nazarian Mobin, S. S., Karatsonyi, A., Vidar, E. N., Gamer, S., Groper, J., Hammoudeh, J. A., & Urata, M. M. (2011). Is presurgical nasoalveolar molding therapy more effective in unilateral or bilateral cleft lip-cleft palate patients? Plastic and Reconstructive Surgery, 127(3), pp. 1263-9. doi:10.1097/PRS.0b013e318205f3ac.
    Nazarian Mobin SS, et al. Is Presurgical Nasoalveolar Molding Therapy More Effective in Unilateral or Bilateral Cleft Lip-cleft Palate Patients. Plast Reconstr Surg. 2011;127(3):1263-9. PubMed PMID: 21088643.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Is presurgical nasoalveolar molding therapy more effective in unilateral or bilateral cleft lip-cleft palate patients? AU - Nazarian Mobin,Sheila S, AU - Karatsonyi,Ashley, AU - Vidar,Evan N, AU - Gamer,Simon, AU - Groper,John, AU - Hammoudeh,Jeffrey A, AU - Urata,Mark M, PY - 2010/11/20/entrez PY - 2010/11/23/pubmed PY - 2011/4/27/medline SP - 1263 EP - 9 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 127 IS - 3 N2 - BACKGROUND: The purpose of this study was to compare the efficacy of presurgical nasoalveolar molding in treating unilateral versus bilateral cleft lip–cleft palate patients. METHODS: A blinded, retrospective study was conducted with 16 unilateral and 13 bilateral cleft lip–cleft palate patients. Pretreatment and posttreatment facial and intraoral impressions were used to compare soft- and hard-tissue changes. RESULTS: Nasoalveolar molding therapy improves nasal angle in unilateral (p = 0.010) and bilateral cleft lip–cleft palate (p = 0.001) patients, and improves nostril width in unilateral (p = 0.005) and bilateral cleft lip–cleft palate (p = 0.028) patients. Treatment significantly improves nostril breadth only in unilateral cleft lip–cleft palate patients (p = 0.005). Compared with bilateral cleft lip–cleft palate patients, unilaterally affected patients were more asymmetric before and after nasoalveolar molding therapy. Nasoalveolar molding more effectively increases columellar height (p = 0.002) and columellar width (p = 0.002) in the bilateral cleft lip–cleft palate group. Although starting bialar widths did not significantly differ between the two groups, nasoalveolar molding significantly decreased bialar width only in unilateral cleft lip–cleft palate patients (p = 0.032). When the intersegment alveolar cleft distances of the bilateral cleft lip–cleft palate patients were summed, an improvement similar to that in unilateral cleft lip–cleft palate patients was observed. Furthermore, nasoalveolar molding appeared to prevent alveolar width widening as patients continued to grow. CONCLUSIONS: There are differences in efficacy between unilateral and bilateral cleft lip–cleft palate patients undergoing nasoalveolar molding. Understanding these differences may help physicians and dentists better shape expectations. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/21088643/Is_presurgical_nasoalveolar_molding_therapy_more_effective_in_unilateral_or_bilateral_cleft_lip_cleft_palate_patients L2 - http://Insights.ovid.com/pubmed?pmid=21088643 DB - PRIME DP - Unbound Medicine ER -