International College of Dentists

Scientific Poster

Presurgical orthopedic treatment in cleft lip and palate patients: series of cases

  1. Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal;
  2. Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE–MDP), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
  3. Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
  4. Clinical Academic Center of Coimbra (CACC), 3000-354 Coimbra, Portugal
  5. Center for Innovative Biomedicine and Biotecnhology (CIBB), 3000-354 Coimbra, Portugal
  6. CEEMPRE, Department of Mechanical Engineering, University of Coimbra, 3030-788 Coimbra, Portugal
  7. Coimbra Hospital and University Center, Coimbra, Portugal
    *Head of Department.

Onsite author: Francisco do Vale

Objectives: Cleft lip and palate (CLP) represent the most common congenital malformation of the head and neck. Several genetic and epigenetic factors are identified in its etiology. In the first two years of life, several surgeries are performed in order to closure the lip and palate cleft and correction of the nose. In 1999, the first treatment protocol with a nasoalveolar molding (NAM) was defined. The NAM consists of a presurgical orthopedic device that allows the reduction of the size of the cleft and the modulation of the nasal cartilage. The main purpose of this poster is to present two clinical cases that underwent NAM.

Methods: Two patients, one with bilateral CLP and the other with left unilateral CLP, followed at the Institute of Orthodontics of the Faculty of Medicine of the University of Coimbra and the Pediatric Hospital of Coimbra were submitted to the presurgical NAM protocol. The NAMs were placed on the eighteenth day of life and the parents were instructed to put the appliances day and night, removing only to perform daily hygiene. NAM control was performed weekly for 12 weeks until the time of lip closure surgery.

Results: Both cases showed orthopedic modeling with a substantial reduction in the space of the primary palate cleft and greater projection of the nasal cartilage. The changes obtained with the nasoalveolar modeler remained stable after the surgical procedures.

Conclusions: Presurgical treatment with NAM in  CLP patients improves surgical results which may contribute to aesthetic and functional improvement.