Presurgical Treatment of Cleft Lip and Palate Babies with a PNAM Appliance: A Series of Four Case Reports

Abstract

Embryonic development of the head and face are among the most complex prenatal developmental events. Any disturbance during the developmental stage can result in craniofacial abnormalities, and the timing of the disturbance and intensity of the interruption affect the severity and type of the anomaly. Cleft lip and palate are relatively common congenital malformations and are readily diagnosed. Treating cleft lip and palate defects is important because of the severe aesthetic, functional, and serious psychological problems faced by both patients and their parents. It is recommended that cleft lip and palate patients from 0 to 18 years old undergo treatment with a multidisciplinary team. In this series of clinical reports, we describe clinical orthodontic treatment approaches using a presurgical nasoalveolar moulding (PNAM) in newly born unilateral and bilateral cleft lip and palate babies. Three boys and one girl were selected from among other cleft lip and palate patients because some information about the possible aetiology of the clefts was observed and the parents were cooperative during treatment. The objectives of PNAM use in unilateral and bilateral cleft lip and palate patients are to presurgically decrease the severity of the cleft size, maintain a narrower cleft palate, and increase the length of the columella and height of the nostrils. With parental cooperation, the treatment goals were achieved in these cases.