Prosthetic Rehabilitation of Complete Bilateral Cleft Lip and Palate Neonates Using Two Different Appliance Designs.

Objectives: Background: The primary challenge in managing bilateral cleft lip and palate deformity arises from deficient columella and deviated premaxilla. The objective of nasoalveolar molding in such cases is to reconstruct a balanced lip and nose with good columellar length before surgery. There are different techniques for presurgical management of the bilateral cleft lip and palate. However, when rapid and large movements are performed in the patient, the vomer can be deformed, injured, and even fractured, especially at the pre-vomerine suture.Objective:Compare the concept of septal molding appliance with conventional molding appliance in preserving the vomer in complete bilateral cleft lip and palate cases.
Methods: 10 non-syndromic newborns with complete bilateral cleft lip and palate were included in this study with age not exceeding 2 weeks old. The infants were randomly divided into two groups, (Group A) received septal molding appliance while (Group B) received conventional nasoalveolar molding appliances. Impression was taken for the infants with rubber base material poured and processed using heat-cured acrylic resin. The first cast was scanned before the start of treatment (T1) and another impression was taken just before primary cheiloplasty at 4 months of age (T2). The casts were scanned to measure and evaluate the intraoral changes in each group. The data were collected, tabulated, and statistically analyzed using SPSS software.
Results: The significance of the obtained results was judged at the 5% level. There was a statistically significant difference between the two studied groups regarding the deviation of the vomer and posterior arch width.
Conclusions: The use of Septal molding appliances preserved the vomer from deformity and also helped in redirecting its position.