The present study will compare the effectiveness of adhesive nasoalveolar molding (GS-NAM) and conventional nasoalveolar molding on the alveolar ridge, nasal, and labial growth in children with unilateral cleft lip and palate. objectives: - 1. Evaluation of the anatomical position of the greater and lesser segments of the maxilla related to a stable midline anatomical point. 2. Evaluation of the nasal symmetry.
cleft lip and palate can manifest as an independent anomaly, be associated with a syndrome, or present as a complex condition. Unilateral clefts are notably more common, occurring nine times more frequently than bilateral clefts. Additionally, it predominantly affects males, with a male-to-female ratio of 2:1. Common clinical features in unilateral cleft lip and palate cases involve structural changes in the nose, lip, palate, and alveolar arch. Peri-oral tissues lack continuity, and on the affected side of the nose, you can observe wider nostrils and a downward-pointing alar rim. Additionally, the columella and nasal tip shift towards the unaffected or normal side, accompanied by the displacement of the maxillary alveolar segments towards the lateral side. Conventional treatment for cleft lip and palate historically comprised numerous surgical procedures, including secondary revisions and alveolar bone grafting. However, even with these multiple interventions, concerns persisted regarding suboptimal aesthetics. Therefore, the pursuit of non-surgical treatment options that can mitigate the severity of this deformity during early life is greatly desirable. The introduction of the presurgical Nasoalveolar molding (NAM) procedure has offered an alternative, allowing for the avoidance of traditional secondary surgeries while achieving improved outcomes. . These interventions should be initiated within the narrow time frame from birth to four months, as estrogen levels decrease within the first four months after birth, making this period optimal for tissue manipulation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
compare the effectiveness of adhesive nasoalveolar molding (GS-NAM) and conventional nasoalveolar molding on the alveolar ridge, nasal, and labial growth in children with unilateral cleft lip and palate
Faculty of dental medicine
Cairo, Egypt
Faculty of Dental Medicine (Boys, Cairo), Al- Azhar University
Cairo, Egypt
Posterior ends of alveolar crest
width between the most posterior ends of the alveolar crest in the greater segment and lesser segment
Time frame: 3 months
Middle ends of alveolar crest
width between the middle parts of the cleft palate (The intersection points between the palatally extended buccal frenum sulcus line and the palatal gingival groove in the greater and lesser segment
Time frame: 3 months
Anterior ends of alveolar crest
The widths of the cleft gap (The anterior endpoint of the alveolar crest in the greater and lesser segment)
Time frame: 3 months
Mid line of maxilla
Inc-Sagittal: - Perpendicular distance from Inc point (The intersection points between the labial frenum-incisive papilla point line and the alveolar crest of the premaxilla in the greater segment) to sagittal line (The perpendicular line to the PG-PL line)
Time frame: 3 months
Angulation of maxilla
Mid-Inc)-Sagittal: - Angle among Inc point, midpoint in PG -PL, and sagittal line
Time frame: 3 months
Alar base width
Total width correction of alar base width.
Time frame: 3 months
Columella length.
Columella length correction
Time frame: 3 months
Columella angle deviation.
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Columella angle deviation correction
Time frame: 3 months
Nostril height and width on the cleft side.
Nostril height and width on the cleft side correction
Time frame: 3 months
Nostril height and width on the non-cleft side
Nostril height and width on the non-cleft side correction
Time frame: 3 months
Nasal ridge deviation.
Nasal ridge deviation correction
Time frame: 3 months