Abstract

Introduction: Pre-surgical Orthopaedic Treatment (POT) aims to the active moulding of the alveolar processes, nasal cartilage and columella, improving the shape of the maxillary arch and also reducing the size of cleft lip and palate (CLP) in affected neo- nates. Early intervention by paediatric dentists using POT may imply better aesthetics and functional results, which may reduce surgical procedures improving the quality of life of CLP-affected children. Case report: Case one. A 16-day-old patient presented a unilat- eral CLP with 2 mm interalveolar cleft width. After maxillary impression, the orthopaedic appliance was placed improving suckling reflex. After one week, the nasal moulding extension was added to model the nasal cartilage and relocate the columella to midline. The follow up was undertaken every 7 days for 3 months. At month fourth, the primary surgery of the lips and gingivoperiosteoplasty were undertaken. Fifteen days after sur- gery, a nasal conformer was used for three months obtaining sat- isfactory aesthetic results. Case two. 14-day-old patient presented a unilateral CLP with 12 mm interalveolar cleft width. The orthopaedic appliance was placed with weekly checkups. After 5 weeks, the interalveolar cleft width was reduced to 6 mm and the nasal moulding extension was added. After appliance activa- tion (4 months) the surgery took place. Fifteen days after the surgery, the nasal conformer was used with similar results as before. Comments: Early POT seems to improve orofacial conditions for primary surgery favouring better aesthetic and functional results in CLP-affected children. However, long-term success of the nasal conformer needs further research.