Nasoalveolar Molding Research Articles

Cytotoxicity Evaluation of Various Composite Resin Materials: An In Vitro Study.

Aim This study aimed to determine and comparethe cytotoxicity of light-cured composite resin (Enlight light cure composite (Ormco, Glendora, California, USA)), light-cured acrylic resin (Orthocryl LC (Dentaurum, Ispringen, Germany)), and the self-cure acrylic (DPI RR cold cure acrylic (Dental Products of India, Bombay Burmah Trading Corporation Ltd., Mumbai, India)) material and to determine which component is best to be used for the purpose of nasal stent fabrication in the nasoalveolar molding (NAM) technique for cleft therapy. Methods Circular discs made from Enlight light cure composite, Orthocryl LC, and self-cure acrylic were submerged for 24 hours in gingival fibroblast media (three discs of each material) and control medium (three discs of each material) that were both contained in plates. After analyzing the optical densities of the plates, the cytotoxicity of the products was assessed by measuring cell viability using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The compiled data was analyzed using IBM SPSS Statistics for Windows, V. 23.0 (IBM Corp., Armonk, NY). The normality of the data was evaluated using the Shapiro-Wilk test.One-way analysis of variance (ANOVA) and pairwise comparison made with Tukey's honestly significant difference (HSD) post hoc test with a significance level (p) of 0.05 were considered. Results The percentage of cell viability was between 80% and 150%. A significantmean difference was noted in the cell viability between the three groups (p=0.009). High mean cell viability was seen in Orthocryl LC. However, there was no significant mean difference between Orthocryl LC and Enlight light cure composite material (p=0.854). Conclusion Both Orthocryl LC and Enlight light cure composite materials are less cytotoxic when compared to the self-cure acrylic resin material and can be used to fabricate the nasal stent component for infants with cleft defects, undergoing NAM procedure.

Nasolabial morphological changes in patients with unilateral cleft lip and palate using a Korat-modified nasoalveolar moulding appliance with primary correction.

The objective of this study is to measure the morphological changes of the nose and lip in patients with unilateral cleft lip and palate before and after cheiloplasty with primary rhinoplasty (primary correction) in conjunction with Korat-NAM usage. Longitudinal cohort study. Cleft Center Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand. Twenty-six patients with unilateral cleft lip and palate. Control group: only active obturator before primary correction. Experimental group: an active obturator and Korat-NAM I before primary correction. A customized endotracheal tube was retained in the nostril for 3 weeks before switching to Korat-NAM II for 1 year. Six measurements comprising nostril rim length, nostril height, nostril sill width, columella angle, vertical lip height, and horizontal lip length were measured from the patients' photographs. All measurements, except the columella angle, were reported as the cleft side/non-cleft side value ratio. Measurements were taken at the initial appointment, immediately before, 3 weeks after, and 1 year after primary correction. Nostril rim length ratio, nostril height ratio, nostril sill width ratio, columella angle on the cleft side, and vertical lip height ratio were improved using Korat-NAM before and 3 weeks after primary correction. Nostril rim length and height ratios were significantly better than the control group. Korat-NAM improved nose and lip morphology before primary correction. An overcorrection improved the nose and lip morphology on the cleft side. The nostril rim length and vertical lip height on the cleft side also improved with Korat-NAM II 1 year after primary correction.

Presurgical management trends and nasoalveolar molding usage for infants with cleft lip and palate in the capital of a developing country.

Nasoalveolar molding (NAM) application is among presurgical management (PSM) techniques used for infants with cleft lip and palate (CLP). It helps to approximate the palatal cleft and to reshape the nasoalveolar complex prior to primary lip repair. This study aimed to explore types of PSM and the dental speciality provision for infants with CLP in Baghdad. The status of NAM usage and surgeons' perceptions toward NAM usage were assessed. This is a cross-sectional paper-based questionnaire study that collected responses of surgeons perform primary lip and nose repair regarding PSM. The questionnaire was distributed amongst public and private hospitals in Baghdad. Twenty surgeons were enrolled (only those surgeons who perform primary repair for infants with CLP); two females and eighteen males. The majority of participants' responses suggested that the majority of infants with CLP were provided with baby feeding plates and lip straps. Six surgeons reported that a percentage of their patients who have been provided with NAM. PSM in Baghdad was mostly supplied by orthodontists and plastic surgeons, and the next most likely providers were prosthodontists. 82.35% of the surgeons found that primary surgical repair procedures were easier with NAM than for the other infants. The rest have not perceived any differences. Orthodontists, surgeons and prosthodontists were involved in providing PSM. Baby feeding plates and lip straps were the most common PSM in Baghdad, although NAM is not uncommon. Most surgeons believe that using NAM made surgical procedures easier and permitted the prediction of surgical outcomes.

Effects of nasoalveolar molding on nasolabial aesthetics in patients with cleft lip and palate during pre-adolescence: A systematic review and meta-analysis of retrospective studies.

This study aims to analyze long-term effects of nasoalveolar molding (NAM) as a part of cleft primary management protocols on nasolabial aesthetics for patients with non-syndromic cleft lip and palate by conducting a systematic review and meta-analysis. Six electronic databases and two journals were searched up to July 2023. Studies comparing nasolabial outcomes between NAM and non-NAM protocols were selected for further analysis. Nasolabial aesthetics were the outcome of interest. Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis and subgroup analysis were performed. Seven retrospective cohort studies were selected for a qualitative review and four for a quantitative analysis. The risk of bias assessment was moderate for most studies. Only studies utilizing the Asher-McDade rating (AMR) were included for meta-analyses. The protocols with NAM exhibited a significantly lower AMR score for vermillion border than other protocols. AMR scores for nasal form and nasal symmetry from protocols with NAM were significantly lower than protocols without any pre-surgical infant orthopaedics (PSIO) but not significantly different from protocols with other PSIO techniques. The AMR score for nasolabial profile from protocols with NAM was not significantly different from other protocols. However, subgroup analysis demonstrated that protocol combining NAM and primary rhinoplasty significantly lowered AMR scores for nasal form, nasal symmetry and nasolabial profile. For patients with unilateral cleft lip with or without palate (UCLP), this study found that a protocol combining NAM and primary rhinoplasty improved nasolabial outcomes while a protocol with NAM alone offered only limited benefits. For patients with BCLP, the available evidence remains inconclusive. Performing NAM in combination with primary rhinoplasty improves nasolabial aesthetics in patients with UCLP. PROSPERO (CRD4202128384).

Prospective study of nasal growth in bilateral cleft lip and palate patients after naso-alveolar moulding and primary columella lengthening compared to controls at 5, 10 and 20 years.

A short columella, wide nostrils and a flat nasal tip are common features in patients with bilateral complete cleft lip and palate (BCLP). The objective of this study was to evaluate nasal morphology during growth in patients treated with naso-alveolar moulding (NAM) and primary surgical columella lengthening (PCL) compared with matched non-cleft individuals. Prospective longitudinal case-control study. Thirty-four consecutively treated BCLP patients at 5 and 10 years and at the end of growth (19.7 ± 2.0 years) were compared through normalized photogrammetry to a control of 34 age and sex-matched non-cleft individuals. Regression Models for Panel Data assessed how nasal measurements were influenced by surgery, age and gender. Nasal protrusion was equal to non-cleft controls at all ages. Length of the columella was also comparable to controls at 5 and 10 years, but significantly shorter at the end of growth. Inter-alar and nasal tip width and nasolabial angle were significantly wider than controls at all ages: More than 60% of the patients have asked for correction of the nasal width, but no early surgery for columella lengthening was needed. NAM and PCL have provided a nasal projection close to that of non-cleft individuals until adulthood, while length of the columella was physiological at 5 and 10, but shorter than controls at age 20. Width of the nasal tip and width of the alar bases were significantly wider than the controls and eventually required secondary nasal width correction in over two thirds of the sample.

The Burden of Care of Nasoalveolar Molding: An Institutional Experience.

Nasoalveolar molding (NAM) is an early presurgical intervention to facilitate primary cleft lip repair by reducing cleft severity and improving labial and nasal form. However, it continues to be associated with the burden of care that influences access and completion of therapy. The authors, therefore, aim to determine the burden of care of NAM therapy for families seeking treatment at a high-volume urban cleft center. A retrospective study of all patients undergoing primary cleft repair between 2012 and 2020 was performed. Patients were grouped based on whether or not NAM therapy was offered. Variables including physical, psychosocial, and financial factors were assessed. Two hundred and thirty patients underwent primary cleft repair between 2012 and 2020. Of these, 176 patients were indicated for NAM, with 4% discontinuing, and 54 patients did not undergo NAM. The 169 patients who completed NAM had a mean duration of treatment of 13.6±8.8 wks consisting of 15±6 scheduled NAM adjustment visits and 1±1 unscheduled visit made urgently to assess caregiver concerns. The mean travel distance was 28.6±37.1 miles. Eighty-four percent of caregivers were married, and 16% did not have English as a primary language. Though 57% had private insurance, 43% of patients received charity support for their treatment. NAM is a finite presurgical intervention that requires caregivers to participate in patient care for approximately three months of their early life. The decision to pursue NAM should be considered alongside the burden of care for caregivers to complete treatment.

A Bibliographic Analysis of Indian Contribution in Application of Presurgical Naso-Alveolar Molding in Cleft Lip/Palate Infants

Background: Pre-surgical nasoalveolar molding is a novel treatment modality applied in cleft lip/palate infants prior to surgery. Numerous articles have been published in the literature. Using Bibliographic analysis tt is essential to know the nation wise contribution of total research output towards PSNAM. Aim: To evaluate Indian contribution globally on the domain ‘application of presurgical naso-alveolar molding in cleft lip/palate infants’ by analysing all the studies published till date. Materials and Methods: A detailed bibliographic database search was carried out using PUBMED for a period of two months from September to October 2023. Different Mesh keywords in several combinations were used to obtain the articles. All types of published articles from inception till October 2023 and were published in English language were considered for this bibliographic analysis. The selected published articles pertaining to Indian Institutions, researchers or authors and specialties were tabulated and evaluated to obtain the overall bibliographic details. Results: India’s global contribution was 6.65% (total 31 articles). More number of case reports (n=15) were published followed by case control studies (n=5). Highest publication credit was conquered by author Thakur S (n=5) and Journal of Indian Prosthodontic Society and Contemporary clinical dentistry journals shared maximum articles published (n=5 each) having impact factor of 0.265 and 1.2 respectively. South zone contribution was highest (n=12) in that Karnataka state bagged with highest contribution. H.P. Government Dental College and Hospital and regarding specialty, Pediatric and Preventive Dentistry contributed more research work towards PSNAM. Conclusion: From the present bibliographic review, it was concluded that there is a growing demand and increasing trend in the application of PSNAM in cleft lip/palate infants. The current review provides insight into the current literature on PSNAM and paves for further research and its application in clinical practice

Evaluating Parental Anxiety Levels Associated with Nasoalveolar Molding in Cleft Lip and/or Palate Patients

To find out the impact of NAM, gender of the parents or the patients and type of cleft on the anxiety levels of the parents of clp patients.This quasi experimental study included The parents of newborn unilateral or bilateral cleft lip and/or palate patients. The VASA was administered at 30 parents were a part of the study .The mean anxiety level at T0 was greater than at T1,T2 and T3 which was significant. The gender of the patients and the parents did not affect the anxiety levels at various time intervals. Anova test showed that the anxiety levels were not affected by the type of cleft except at T2.The NAM seems to impact the anxiety levels of parents significantly. Also. The gender of the patient or the parents does not have an impact on the anxiety levels.

Outcomes of Presurgical Nasoalveolar Molding using Modified Nostril Retainers in Patients with Unilateral Cleft Lip and Palate at an Average Follow-up of 2 Years.

Presurgical nasoalveolar molding (PNAM) using a modified nostril retainer is a new treatment approach. This study aimed to evaluate the outcomes of early nasal molding using this approach with an average follow-up of 2 years in patients with severe unilateral cleft lip and palate. This retrospective study included 18 patients with unilateral cleft lip and palate without genetic syndromes who underwent PNAM with modified nostril retainers. The Grayson technique was employed with an intraoral plate to approximate cleft segments. Nasal molding was initiated before reducing the cleft width to 5 mm. Measurements, including alar base height ratio (ABHR), nasal floor width ratio (NFWR), columellar length ratio (CLR), columellar angle (CA), and nostril axis inclination on the cleft and non-cleft sides (NAI-C and NAI-NC, respectively), were calculated from standard photographs taken before PNAM (T1), after PNAM (T2), after an average of 1.81 months post-surgery (T3), and after an average of 2.2 years after T3 (T4). Pairwise comparisons of values at the four time points were conducted. NFWR, CLR, CA, NAI-C and NAI-NC significantly increased after PNAM (p<0.05). However, no significant change was observed in ABHR (p>0.05) from T1 to T2. These outcomes were maintained at T4, and no patient developed a mega nostril. The use of a modified nostril retainer for nasal molding appears to provide stability during the high probability of relapse reported in the literature.

The Effect of Presurgical Nasoalveolar Molding on Oronasal Fistula Following Primary Palatoplasty.

Presurgical nasoalveolar molding (PNAM) is widely used in cleft care protocol. This study investigated the correlation between PNAM and oronasal fistula after primary palatoplasty. A case-controlled study of 80 unilateral and bilateral complete cleft palate patients who underwent cleft palate repair were enrolled. Patients were divided into 2 groups: (1) no PNAM use and (2) PNAM use. The incidence of oronasal fistula and postoperative complications were compared between groups. Forty patients in each group demonstrated the same baseline characteristics. The PNAM group showed a significantly lower postoperative oronasal fistula rate (15% versus 50%, P =0.003). Palatal cleft width wider than 12.5mm increases the odds ratio of fistula formation by 1.19-fold ( P =0.037), and the PNAM protected against postoperative palatal fistula formation (odds ratio 0.20, P =0.003). Presurgical nasoalveolar molding can reduce postoperative oronasal fistula in wide-gap Veau type III and IV cleft palate.

The use of Korat-modified nasoalveolar molding devices in patients with unilateral complete cleft lip and palate with a 5-year follow-up

The nasoalveolar molding (NAM) appliance has been the appliance of choice for pre-surgical orthopedics to improve nasal and lip morphology, and optimally align the alveolar segments before cheiloplasty. However, the appliance has some limitations, including its complexity and long clinical chair time for appliance adjustments. In this case report, we present a patient treated for a right complete cleft lip and palate using three types of Korat modification for NAM with a 5-year follow-up. This study demonstrated that the Korat-NAM improved the aforementioned issues and was suitable for patients at different stages before and after lip and palate repair.

MRI Modeling for 3D Printed Fabrication of Nasoalveolar Molding Appliance in Patients With Cleft Lip and Palate

Purpose: Present a novel technique for fabrication of nasoalveolar molding (NAM) appliances for neonates with cleft lip and palate (CLP) using magnetic resonance imaging (MRI). Study design: Proof-of-concept study. Setting/Participants: One patient with unilateral CLP was recruited for participation in this study at our institution. Interventions: This study employed 2 different methods for creating a NAM appliance, which is used in patients with CLP to improve anatomic positioning of the orofacial cleft in preparation for primary cheiloplasty. The patient underwent intraoral impression for traditional fabrication of a NAM appliance (PMMA-NAM) and also MRI of the face for digital fabrication of a NAM appliance (CAD-NAM). The 2 appliances were then compared using landmarks for measurements. Primary Outcome: Landmark measurements on NAM appliances; Clinical interchangeability of NAM appliances. Results: There was a statistically significant difference in the external arch width between the CAD-NAM and the PMMA-NAM. All other NAM measurements were statistically similar. Additionally, there was clinical success in the interchangeable fit of both appliances on both models. Conclusions: This technique could potentially eliminate the need for creation of an intraoral impression, as well as the adverse events associated with this, in the fabrication of NAM appliances. Larger studies are necessary to further define the efficacy of this novel approach and generalizability to other patients with CLP.

Morphologic Changes Following Nasoalveolar Molding (NAM) in Complete Unilateral Cleft Palate: A 3D Analysis of 3D Stereophotogrammetry

Morphologic Changes Following Nasoalveolar Molding (NAM) in Complete Unilateral Cleft Palate: A 3D Analysis of 3D Stereophotogrammetry

An evaluation of the customized nasal clip protocol for bilateral cleft lip and palate presurgical infant orthopaedics.

Nasoalveolar moulding (NAM) has resulted in profound outcomes in the treatment of bilateral cleft lip and palate patients, including non-surgical columellar lengthening and nasal moulding. We examine an innovative alternative that is less invasive, yet provides similar results. In this study, we describe a novel approach using the Customized Nasal Clip Protocol (CNCP™) and compare the treatment outcomes of a small cohort of infants with bilateral cleft lip ± palate with published results of the Grayson nasoalveolar moulding protocol. A cohort of six bilateral-cleft-affected patients was evaluated for this study. Standardized frontal and worm's eye view photographs were obtained, and clinical measurements were utilized to garner columellar length measurements and nostril height comparisons. The initial and post-surgical results were statistically compared with a student's t-test (p < .05). Inclusion and exclusion criteria were applied to the cohort, which will be described. The resulting columellar length and nostril height increases of the CNCP™ group were comparable to a published cohort of subjects that have undergone nasoalveolar moulding. The nasal changes were found to be significant with a p-value <.01. The CNCP™ cohort also had fewer clinic visits, no complications that led to complete pauses of active treatment, and the benefit of receiving comprehensive treatment that was initiated at their first clinical presentation, in comparison to traditional NAM patients. The increase of columellar length and nostril height that resulted from utilizing the CNCP™ in bilateral cleft patients met the treatment goals of presurgical infant orthopaedics, with results on par with published results of NAM. These results, paired with the reduction in patient, family, and provider burden, further support the continued use and development of the CNCP™ for appropriate patient populations.

Alarm Signals to Postpone Feeding Plate Fabrication and Nasoalveolar Molding.

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Lessons Learned from a Single Institution's Eight Years of Experience with Early Cleft Lip Repair.

Background and Objectives: The traditional approach in managing wide cleft lip deformities involves presurgical nasoalveolar molding (NAM) therapy followed by surgical cleft lip repair between three and six months of age. This institution has implemented an early cleft lip repair (ECLR) protocol where infants undergo primary cleft lip repair between two and five weeks of age without NAM. This study aims to present this institution's ECLR repair protocol over the past eight years from 188 consecutive patients with unilateral or bilateral CL/P deformity. Materials and Methods: Retrospective review was conducted at Children's Hospital Los Angeles evaluating patients who underwent ECLR before three months of age and were classified as American Society of Anesthesiologists (ASA) class I or II from 2015-2022. Anthropometric analysis was performed, and pre- and postoperative photographs were evaluated to assess nasal and lip symmetry. Results: The average age at cleft lip repair after correcting for gestational age was 1.0 ± 0.5 months. Mean operative and anesthetic times were 120.3 ± 33.0 min and 189.4 ± 35.4, respectively. Only 2.1% (4/188) of patients had postoperative complications. Lip revision rates were 11.4% (20/175) and 15.4% (2/13) for unilateral and bilateral repairs, respectively, most of which were minor in severity (16/22, 72.7%). Postoperative anthropometric measurements demonstrated significant improvements in nasal and lip symmetry (p < 0.001). Conclusions: This analysis demonstrates the safety and efficacy of ECLR in correcting all unilateral cleft lip and nasal deformities of patients who were ASA classes I or II. At this institution, ECLR has minimized the need for NAM, which is now reserved for patients with bilateral cleft lip, late presentation, or comorbidities that preclude them from early repair. ECLR serves as a valuable option for patients with a wide range of cleft severity while reducing the burden of care.

Schematic Treatment Tree for the Presurgical Nasoalveolar Moulding of Patients with Cleft Lip and Palate.

Cleft lip and palate is the most common and unfortunate congenital defect that is debilitating for both the patients and their parents. Such complex condition demands for a precise and judicious management, as its outcome can drastically influence the quality of life of the child. To provide a concise treatment algorithm or tree which might guide the clinicians and make it easier for them to opt for a better treatment option when confronting different severities and types of this defect. The clinical experience at our center alongwith review of current literature is used to propose a decision making treatment tree. For the better aesthetics, function and ease of cosmetic surgery, several presurgical procedures have been introduced including the nasoalveolar moulding (NAM) appliance, adhesive tapes with nasal elevators, Figueroa's appliance, Hotz appliance, etc. The schematic decision-making tree may prove beneficial to the healthcare providers specially pedodontists who frequently come across such situations to choose the best treatment option for their patients.

Dynamic Molding of Cleft Nasal Cartilage in Unilateral Complete Cleft Lip and Palate Using Simple Segmented NAM.

Nasal morphology remodeling by nasoalveolar molding (NAM) before primary lip repair gives better post-surgery outcomes. However, traditional NAM has high technical sensitivity, a steep learning curve, frequent need for modifications, and interrupts lifting forces on the nasal cartilage during oral movements, thereby reducing overall efficacy of device. To eliminate interaction and interdependency of the nasal bulb with alveolar molding plate, we propose segmenting NAM (SNAM) into nasolabial complex molding (NCM) and alveolar complex molding (ACM). NCM addresses ala-septum, lip-premaxilla via lambda-nasal hook and lip taping. ACM addresses palate-alveolus via Yen-modified feeding plate. When the hook is suspended by elastic traction, nasal complex undergoes a natural rotation, where cleft-side ala lifts and septum medializes. Lip taping and feeding plate augment positive molding of cleft segments and maintain transverse relation. The current study outlines SNAM treatment strategy and assesses the effect on nasal deformity. Retrospective observational cohort study set in a comprehensive cleft care centre. Twenty patients with unilateral complete cleft lip and palate who underwent SNAM were selected. Retrospectively, standardized basilar views, pre-, and post-SNAM therapy were evaluated for nostril height, and nostril width, as a ratio of cleft to non-cleft side along with columellar deviation angle. SNAM resulted in significantly improved nostril symmetry with no complications observed. Nostril height ratio increased from 0.35 ± 0.10 to 0.78 ± 0.17. Nostril width ratio decreased from 3.14 ± 0.66 to 2.18 ± 0.42. Columellar deviation angle increased from 26.5 ± 6.30 to 58.5 ± 9.88 degrees. Dynamic correction of the nasal deformity in UCLP is possible through SNAM therapy.

Effects of Nasoalveolar Molding on Maxillary Arch Dimensions and Malocclusion Characteristics of Deciduous Dentition Patients with Cleft Lip and Palate.

To evaluate the effects of nasoalveolar molding (NAM) therapy on maxillary arch dimensions and malocclusion characteristics in patients with unilateral (UCLP) and bilateral cleft lip and palate (BCLP). Patients in deciduous dentition were referred to the institutional department of orthodontics. The NAM group consisted of 21 patients with UCLP (mean age 4.7±0.7 years) and 12 patients with BCLP (mean age 4.8±0.7 years). Sixteen patients with UCLP (mean age 4.9±0.9 years) and 5 patients with BCLP (mean age 5.4±1.1 years) were included in the non-NAM group. The plaster models of all patients were digitized. Dental arch dimensions and malocclusion characteristics were analyzed via digital software. One-way ANOVA with Bonferroni correction was used for statistical analysis. Intercanine and intermolar widths showed statistically significant differences according to the cleft type (P<.01). There was no statistically significant effect of NAM therapy on maxillary arch parameters and malocclusion characteristics (P>.05). The prevalence of anterior crossbite was 12.1% in the NAM group, and 23.8% in the non-NAM group. NAM therapy did not affect the maxillary arch dimensions and malocclusion characteristics in patients with UCLP and BCLP. The cleft type was the main factor, leading to a significant difference in maxillary widths.

IMPACT OF NASOALVEOLAR MOLDING ON MAXILLARY ARCH DIMENSIONS AND MALOCCLUSION CHARACTERISTICS IN PEDIATRIC PATIENTS WITH CLEFT LIP AND PALATE DURING PRIMARY DENTITION

Unilateral complete cleft lip and palate (UCLP) are congenital disabilities when a baby's lip or mouth does not form properly during early pregnancy. This retrospective study investigated the long-term effects of passive alveolar molding (PAM) and nasoalveolar molding (NAM) on cleft width and maxillary growth parameters in children with UCLP. A retrospective study of children with UCLP was enrolled and divided into two groups: PAM and NAM. Cleft width measurements were obtained at baseline and regular intervals during the follow-up period. Maxillary growth parameters were also assessed, including arch width, dental occlusion, and facial symmetry. Data were analyzed using descriptive statistics, chi-square tests, and linear regression models. Data was collected from 52 patients according to the inclusion criteria. The NAM group consisted of 22 patients with UCLP (mean age of 3.98 ± 1.6 years) and 12 patients with BCLP mean age of 3.81 ± 1.9 years. Fourteen patients with UCLP (mean age 3.9 ± 1.9 years) and four patients with BCLP and mean age 4.4 ± 2.1 years were included in the non-NAM group. It is concluded that the results of our study suggest that passive alveolar molding (PAM) and nasoalveolar molding (NAM) have a significant impact on cleft width reduction and maxillary growth in unilateral cleft lip palate (UCLP).