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EFFICACY OF PRESURGICAL NASOALVEOLAR MOLDING WITH MODIFIED ORTHOPEDIC PLATE FOR THE TREATMENT OF UNILATERAL CLEFT LIP AND PALATE

Dr. Shaista Aziz, Dr. Fatima, Dr. Fariha Sameen, Dr. Mohsin Majeed, Dr. Sara Izhar

Objective: To present a modified device and treatment protocol for nosalveolar molding before surgery in a newborn with a unilateral cleft lip and palate and determine its efficacy. Study design: A Retrospective Study. Location and Duration: In the Orthodontic department of Nishtar Institute of Dentistry (NID), Multan for One-year duration from July 2017 to July 2018. Methods: This process involves the use of an orthopedic plate with acrylic nasal stent together with a sterile adhesive strip. The plate is adjusted every week for alveolar molding. For nasal casting, soft acrylic is slowly added to the nasal acrylic stool to remove cartilage of the alar dome and to mold the pressed and concave lower lateral cartilage on the affected side. Activation was performed once a week until three months of age. Results: The plate avoided the tongue widening effect and used the functional movements of the orofacial muscle system to orient the main segment medially to its normal position. This device provided a reduction of 4.5 mm in the anterior region of the cleft gap. The shape of the cartilaginous septum, the alar tip and the medial and lateral walls were shaped to resemble the almost normal shape of these structures. Conclusion: The technique helps to improve the projection of the nasal tip before the alveolar position, alignment of the nasal septum, nasal symmetry and repair of the lips. This device minimizes lips scar and gives the patient the aesthetic result. Key words: unilateral cleft, nasoalveolar molding, modified orthopedic plate, acrylic nasal stent.

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