Comparison of Dental Relationship and Craniofacial Development in Children With Unilateral Cleft Lip and Palate Treated With/Without Presurgical Nasoalveolar Molding

Objective To evaluate long-term effects of presurgical nasoalveolar molding (PNAM) on occlusal relationships and craniofacial development in children with unilateral cleft lip and palate (UCLP) using the 5-year-olds’ index and cone-beam computed tomography (CBCT). Design Retrospective cohort study. Setting Tertiary-level Class A specialized stomatological hospital. Participants Sixty-four patients with complete UCLP. Interventions Thirty patients underwent PNAM treatment, and 34 patients did not. Main Outcome Measure CBCT scans were used to assess dental occlusion via the 5-year-old index and to measure craniofacial variables. Intergroup differences were analyzed using the Mann–Whitney U test and the chi-square test, while the correlation between occlusion and craniofacial variables was examined using the Pearson correlation coefficient. A P value of less than .05 was considered statistically significant. Results A comparison of 5-year-olds’ index scores in the two groups showed median scores of 3.0 (PNAM group) and 3.5 (non-PNAM group), respectively, with no significant difference found. For prognosis, no significant difference in orthognathic surgery need was found, but the PNAM group had a higher nonsurgery rate (60%) versus 50% in the non-PNAM group. In craniofacial development, the PNAM group had significantly longer maxillary length; favorable prognosis group showed smaller SNB angles, shorter mandibular body, larger ANB angles, and longer maxillary length. Correlation analysis showed 5-year-olds’ index positively correlated with SNB/mandibular body length, and negatively with ANB/maxillary length. Conclusions Early childhood evaluations showed that treatment with/without PNAM in the neonatal period was not a major factor influencing occlusal relationships or craniofacial development in patients with UCLP. Furthermore, correlation between 5-year-olds’ index and skeletal morphology in children with UCLP has been confirmed.