Cleft of the primary and secondary palate in human beings is a frequent congenital malformation occurring once in 800 live births.' In Michigan, this congenital defect is incident once in 740 live births.2 Although both genetic and environmental forces are involved in cleft formation, the genetic mechanism has not been described adequately or have specific environmental agents been identified. ...

BACKGROUND The optimal time to create symmetry in a cleft lip is during primary repair; a secondary effort later is more difficult due to potential scarring and possible tissue deficiency of the repaired cleft lip. A plethora of methods for secondary correction have been described that have the goal of constructing the philtral column, ameliorating bad scar results, and augmenting lip volume, f...

The principle objective of presurgical nasoalveolar molding (NAM) is to reduce the severity of the initial cleft deformity. This enables the surgeon and the patient to enjoy the benefits associated with a repair of a cleft deformity that is of minimal severity. Retraction of the premaxilla, presurgical elongation of the columella, correction of the nasal cartilage deformity, alignment of the cl...

Cleft lip and palate is one of the most common birth defects occurring 1 of every 700 live births. Historically, cleft lip and palate care typically involves the use of presurgical infant orthopedics appliances (PIOA) fabricated by a pediatric dentist as an adjunct to the overall management of the defect approximate the cleft segments prior to surgical repair. However, the necessity of presurgi...

OBJECTIVE To present technical modifications to the original presurgical nasal remodeling appliance introduced in 1991. The purpose of the modifications is to improve the cleft nasal deformity before unilateral and bilateral cleft lip repair. METHOD The principle behind this technique, known as dynamic presurgical nasal remodeling (DPNR), is the use of the force generated during suction and s...

BACKGROUND The burden of care for children with cleft lip and palate extends beyond primary repair. Children may undergo multiple secondary surgeries to improve appearance or speech. The purpose of this study was to compare the use of secondary surgery between cleft centers. METHODS This retrospective cohort study included 130 children with complete unilateral cleft lip and palate treated con...

Management of a neonate with cleft lip and palate and assuring the parents regarding the future well being of the child can be a challenging task. Timely referral by pediatrician and treatment by an Orthodontist and a Plastic Surgeon can help in limiting the deformity to its minimum and aid in normal growth and development of the child. This paper describes the treatment of two neonates with un...