Three-dimensional evaluation of the effect of nasoalveolar molding on the volume of the alveolar gap in unilateral clefts.

Over the last few decades it has been shown that nasoalveolar molding (NAM) has had an effect on the correction of nasal cartilage deformities and the alveolar process. This three-dimensional (3D) analysis evaluated the effects of NAM on the alveolar cleft region in patients with unilateral cleft lip and palate. Alveolar gap volumes were measured in a retrospective review of 40 dental casts of 20 patients with unilateral clef lip and palate before and after treatment. Ten patients who began undergoing NAM immediately after birth were included in this study. An additional 10 patients with unilateral clefts but without NAM were included as a control group. All of the casts (pretreatment and post-treatment) were 3D scanned, and the cleft volumes and anterior gap widths underwent computer-aided evaluations. NAM resulted in a significant reduction (p < 0.05) in alveolar gap volume and anterior cleft width from birth until lip closure time, while half of the control group showed slight increases in cleft volume. Based on these results, NAM is an effective and helpful treatment that can be used to significantly reduce alveolar gap volume and anterior cleft width in patients with unilateral clefts. Harmonization of the dental arch and a reduction in the alveolar cleft region are desirable treatment goals.