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NAM vs Lip Adhesion: A Cephalometric Comparison
Jack E. Brooker
Wendy Chen
Joshua M. Barnett
Jesse A. Goldstein
Joseph E. Losee
Lindsay Schuster
University of Pittsburgh
2018-01-30
Presenter: Jack E. Brooker
Affidavit:
Declaration
This work has neither been presented nor published. Jack E. Brooker was instrumental in the conception and undertaking of this study as well as the abstract preparation
Director Name: Vu Nguyen
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
NAM vs Lip Adhesion: A Cephalometric Comparison
Background: Patients with cleft lip and palate frequently undergo nasoalveolar molding (NAM) or lip adhesion (LA) in preparation for repair. The effects of these interventions on cephalometric parameters are reported.
Methods: This is a retrospective study at a tertiary craniofacial center. Patients with unilateral or bilateral cleft lip and palate, who underwent LA or NAM, with follow-up imaging between ages 7-9 were included. Patients were further categorized based on gingivoperiostioplasty (GPP) surgical history. Patients with phase one orthodontic therapy were excluded. Cephalogram analysis was performed. Measures taken: U1-NA(mm) and U1-SN, U1-FN, U1-NA, SNA, SNB, ANB (°). These were compared to Bolton normative measurements.
Results: 50 children who received NAM (22 with GPP) and 18 children who received lip adhesion (2 with GPP) were included. Measurements with statistically significant deviations were:
U1-SN: 73.6° (NAM), 88.4° (LA) (p<0.0033). U1-FH: 83° (NAM), 96.3° (LA) (p<0.0057). U1-Na: -2.1° (NAM) 10° (LA) (p<0.025).
Overjet (mm): -7.07 (NAM), -1.65 (LA) (p<0.028). Proportion of patients with positive dental overjet: 10% (NAM), 35.3% (LA), and negative overjet were 78% (NAM), 47.1% (LA) (P<0.002).
In both unilateral and bilateral clefting: U1-SN, U1-FH, U1-NA, ANB: 82.3, 91.1, 7.6, 0.79° (unilateral), 69.4, 78.8, -9.4, 3.53° (bilateral) (p<0.05).
History of GPP had no significant effect.
Conclusion: LA and NAM cause deviation from normal in U1-SN, U1-FH, U1-NA and overjet with NAM having a greater effect. Bilateral clefts treated with NAM or LA deviated more in these parameters than unilateral clefts. Age at cephalometry and history of GPP had no significant affect.
