Initiation to the management of a case of cleft lip and palate in Madagascar: Naso-Alveolar Molding
1 Department of Dento-Facial Orthopedics, Institute of Tropical Odonto-Stomatology of Madagascar, University of Mahajanga, Madagascar.
2 Department of Surgery, University of Antananarivo, Madagascar.
3 Department of Conservative Odontology Endodontics, Institute of Tropical Odonto-Stomatology of Madagascar, University of Mahajanga, Madagascar.
Case Study
Magna Scientia Advanced Research and Reviews, 2023, 07(01), 030–034
Article DOI: 10.30574/msarr.2023.7.1.0022
Publication history:
Received on 01 January 2023; revised on 10 February 2023; accepted on 12 February 2023
Abstract:
Introduction: Cleft lip and palate represent the most common facial anomaly in the world, with a prevalence of 4.66‰ in Madagascar in 2016. These malformations constitute aesthetic, functional and social damage. Pre-surgical orthodontic management has not yet been applied in Madagascar. The objective of our study was to report the case of a patient with a cleft lip and palate treated pre-surgically by "Naso-Alveolar Molding".
Observation: This is a 3-month-old male child with a bilateral nasolabio-alveolar cleft associated with a total secondary cleft. The initial exo-buccal examination revealed 15mm (left) and 16mm (right) nasal cleft widths, 6mm (left) and 5mm (right) lip cleft widths. The intraoral examination showed 3mm (left) and 4mm (right) of alveolar cleft widths. The treatment consisted of the placement of “Naso-Alveolar Molding”. The evolution having been favorable after a month marked by the reduction of the width of the slits and an aesthetic improvement exo-buccal.
Discussion: Pre-surgical orthodontics is performed in infancy to facilitate feeding, reduce cleft width, and reposition deformed nasal cartilages and alveolar processes; to lengthen the deficient columella in the neonatal period. The main objective being to minimize the extent of surgery that would have to be performed. The malleability of the nasal cartilage at the infantile stage indicates the orthodontist to its conception and to ensure a favorable prognosis.
Conclusion: The treatment of cleft lip and palate consists of a multidisciplinary approach including Dento-Facial Orthopedics.
Keywords:
Cleft palate; Treatment; Orthodontics; Madagascar
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