A Comparative Evaluation of Maxillo–Mandibular Relation in Unilateral Cleft Lip and Palate Patients in Mixed Dentition Treated With or Without Presurgical Infant Orthopaedics: A Three Dimensional Comparative Evaluation

Abstract

ABSTRACT Objective To evaluate the effects of Presurgical Infant Orthopaedics (PSIO) using Nasoalveolar Moulding (NAM) on the maxillomandibular complex in growing children with Unilateral Cleft Lip and Palate (UCLP) during the mixed dentition phase. Methodology This retrospective Cone Beam Computed Tomography (CBCT)‐based study included 40 patients (aged 7–11 years), divided into two groups ( n = 20 each): Group 1—UCLP who underwent PSIO using Modified Grayson's NAM technique; and Group 2—UCLP patients who did not receive PSIO. Maxillomandibular craniofacial structures along with the Temporomandibular Joint (TMJ) were evaluated in transverse, sagittal, and vertical planes using linear and angular parameters. Descriptive statistics were calculated, and intergroup comparisons were performed using one‐way ANOVA. Post hoc analysis (Bonferroni correction) was conducted for pairwise comparisons to identify specific group differences. Results The PSIO group exhibited significantly greater dimensions in Greater Palatine Foramen ( p < 0.001), nasal cavity lateral wall ( p < 0.001), and Intra Orbital Foramen (IOF) axial measurements ( p = 0.002) compared to the no‐PSIO group. Mandibular transverse widths were significantly narrower in the PSIO group ( p < 0.001). Ramal height was significantly higher on both cleft and non‐cleft sides in the PSIO group ( p = 0.001 for both). No significant differences were noted in IOF sagittal dimension ( p = 0.189), palatal plane sagittal length ( p = 0.061), palatal height ( p = 0.789), mandibular length ( p = 0.714), TMJ parameters ( p > 0.2), or ANB angle ( p = 0.712). Conclusion In growing children with UCLP, PSIO using the Modified Grayson's NAM technique was associated with craniofacial development by influencing vertical, transverse, and sagittal dimensions. These early findings highlight the need for long‐term studies to further evaluate developmental outcomes over time.

Affiliated Institutions

• Manav Rachna International Institute of Research and Studies IN

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