Description of Nasoalveolar Molding Process in Neonatal Period of Unilateral Cleft Lip and Palate: A Step by Step


Cleft Lip and Palate
Nasoalveolar Molding


How to Cite

Azhari M, El Hawari W, Rokhssi H, Merzouk N, Bentahar O. Description of Nasoalveolar Molding Process in Neonatal Period of Unilateral Cleft Lip and Palate: A Step by Step. Integr J Med Sci [Internet]. 2021 Jan. 14 [cited 2024 Jun. 15];8. Available from:


Statement of problem. Cleft Lip and Palate (CLP) are common congenital defects of the present day. They result from a failure of facial bud sticking during embryological phenomena. Their therapeutics based on multi-disciplinary care to restore as much as possible the aesthetic and functional prejudices generated by these anomalies.
Purpose. Through this work, we will illustrate, through a clinical case supported at the Consultation and Dental Treatment Center of Rabat, clinical and laboratory stages of realization of Nasoalveolar Molding (NAM).
Material and methods. We describe original techniques used in our service for manufacturing of NAM fireworks and we define recommendations after insertion and follow-up procedures.
Result. Place of NAM in management of these anomalies has increasingly recommended, given limitations of surgery alone to ensure satisfactory aesthetic results. Several fixed or removable appliances has used, in order to reposition gaps in cleft and / or to reshape affected bordering tissues.
Conclusion. Despite the controversies surrounding this therapy, it remains highly recommended and scientifically based.


Punga R, Sharma SM. Presurgical Orthopedic Nasoalveolar Molding in Cleft Lip and Palate Infants: A Comparative Evaluation of Done Cases with and Without Nasal Maxillofacial Stents. J Maxillofac Oral Surg. 2013 Sep;12(3):273-88.

Maull DJ, Grayson BH, CB Cutting, Brecht LL, Bookstein FL, Khorrambadi D, et al. Long term effects of nasoalveolar molding on three-dimensional nasal shape in unilateral clefts. Cleft Palate Craniofacial J. 1999; 36: 391-397.

Cutting C, Grayson B, Brecht L, Santiago P, Wood R, Kwon S. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plastic Reconstr Surg. 1998; 101: 630-639.

Grayson BH, Shetye PR, Cutting CB. Presurgical nasoalveolar molding treatment in cleft lip & palate patients. Cleft J. 2005; 1: 4-7.

Kirbschus A, Gesch D, Heinrich A, Gedrange T Presurgical nasoalveolar molding in patients with unilateral clefts of lip, alveolus and palate. Case study and review of literature. J Craniomaxillofac Surg. 2006 Sep;34 Suppl 2:45-8.

Romero M, Latham R, Romance A, Salvan R. Treatment of an infant with a rare cleft resolved with use of an orthopedic appliance. Cleft Palate Craniofac J. 2003; 40: 642-644.

Singh GD, Levy-Bercowski D, Santiago PE. Three-dimensional nasal changes following nasoalveolar molding in patients with unilateral cleft lip and palate: geometric morphometrics. Cleft Palate Craniofac J. 2005; 42: 403-409.

Matsuo K, Hirose T, Otagiri T, Norose N. Repair of cleft lip with non-surgical correction of nasal deformity in the early neonatal period. Plastic Reconstr Surg. 1989; 83: 25-31.

Ezzat CF, Chavarria C, Teichgraeber JF. Presurgical nasoalveolar molding therapy for the treatment of unilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J. 2007 Jan;44(1):8-12.

Liou EJW, Subramanian M, Chen PKT. Progressive changes in columella length and nasal growth after nasoalveolar molding in bilateral patients: a 3-year follow-up study. Plast Reconstr Surg. 2007 Feb;119(2):642-8.

Spengler AL, Chavarria C, Teichgraeber JF, Gateno J, Xia JJ. Presurgical nasoalveolar molding therapy for the treatment of bilateral cleft lip and palate: a preliminary study. Cleft Palate Craniofac J. 2006 May;43(3):321-8.

Pfeifer TM, Grayson BH, CB Cutting. Nasoalveolar molding and gingivoperiosteoplasty versus alveolar bone graft: an outcome analysis of costs in the treatment of unilateral cleft alveolus. Cleft Palate Craniofac J. 2002 Jan;39(1):26-9.

Yamada T, Mori Y, Mishima K, Sugahara T. Nasolabial and alveolar morphology following presurgical orthopedic treatment in complete unilateral clefts of lip, alveolus and palate. J Cranio-Maxillofac Surg. 2003 Dec;31(6):343-7.

Talmant JC. Cleft rhinoplasty, from primary to secondary surgery. Ann Chir Plast Esthet. 2014 Dec; 59 (6): 555-84. / j.anplas.2014.08.004

Lindsay R. Long-term effect of nasoalveolar molding on midface growth and nasolabial aesthetics in complete unilateral cleft lip and palate patients. Master's thesis 12-2011. Nova Southeastern University. Retrieved from NSUWorks, College of Dental Medicine.

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Copyright (c) 2021 El Hawari W


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