Comparison of short-term effects of presurgical nasoalveolar molding and Hotz’s plate on maxillary arch form in unilateral cleft lip and palate

Publication date: Available online 21 September 2018

Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology

Author(s): Takao Fuchigami, Namiko Kimura, Masahiro Tezuka, Toshiro Kibe, Muhammad Subhan Amir, Toshiya Tsujii, Hokuto Suga, Makiko Hashiguchi, Aya Maeda-Iino, Norifumi Nakamura

Abstract

Objective

To compare the short-term effects of presurgical nasoalveolar molding (PNAM) and Hotz's plate treatment on maxillary arch form in patients with unilateral cleft lip and palate (UCLP).

Materials and Methods

This retrospective study included patients with non-syndromic UCLP who received orthopedic treatment with PNAM (the PNAM group; n = 27) or Hotz's plate (the Hotz's group; n = 29) before lip repair. Maxillary dental casts obtained at first visit and at the time of lip repair were scanned, and the two groups were compared for maxillary form by superimposition of palatal rugae.

Results

By the time of lip repair, the PNAM group exhibited significantly greater posterior movements of the incisal and cleft-edge points of the major segment than did the Hotz's group; additionally, the incisal point had moved laterally to the cleft side. Moreover, the PNAM group exhibited significant smaller alveolar cleft width and alveolar arch length than the Hotz's group at the time of lip repair.

Conclusion

Since PNAM induces rotation of the major segment to the cleft side, it could contribute to the formation of a more symmetrical maxillary arch. However, it might also decrease alveolar arch length before lip repair.

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