Objectives: Clefts of the lip, alveolus and palate are the most common congenital malformations of the head and neck. The basic treatment objective for the cleft lip and palate patient is to restore normal anatomy. Because of the major hard and soft tissue abnormalities in these patients the major treatment objective is to restore the correct skeletal, cartilaginous and soft tissue relationships presurgically. With the presurgical nasolaveolar molding the aim is to approximate the alveolar cleft segments, reshape the nasal cartilages and soft tissue, upright the columella that is deviated to the non-cleft side and achieve a proper nasal base, nostril and lip segments. Approximation of the alveolar processes followed by gingivoperiosteoplasty at the time of lip and nose repair may eliminate the need for the bone grafting. The aim of this study was to evaluate the effects of presurgical nasolaveolar molding appliance on the alveolar ridge and nasal cartialges.

Methods: This prospective study involved 15 patients (9 males, 6 females) having unilateral complete cleft lip and palate. Their mean age was 15 days ranging from 2 days to 3 months. An intraoral molding plate is constructed on the plaster model following the impression taken in the operating room. The reference points digitized on the scanned casts were calculated using a software developed named The Dental Model Planner. Cleft width, arch circumference, anetrior and posterior arch width, arch length as well as columella length were calculated.

Results: The increase in the arch circumference, anterior and posterior arch width arch length were significant. Also the columella length increased significantly with the nasal stant. There was a significant decrease in the cleft width.

Conclusions: Presurgical Nasoalveolar Molding significantly increases the columella length and decrease the cleft width. Therefore the symmetry of nose increases and maintains during early childhood.

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