Early assessment of maxillary arch development is crucial in infants with unilateral cleft lip and palate (UCLP). This study aimed to evaluate three-dimensional changes in the maxillary arch following modified nasoalveolar molding (NAM) and cheiloplasty using digital model analysis. This retrospective study included 25 infants with complete UCLP who underwent modified NAM therapy prior to cheiloplasty. Digital maxillary models were obtained at two time points: T1 on the day of cheiloplasty at 3–6 months of age and T2 on the day of palate repair at 9–18 months of age. Three-dimensional linear and angular measurements were performed to assess transverse, sagittal, and vertical dimensional changes. Changes between T1 and T2 were analyzed using paired t-tests or Wilcoxon signed-rank tests, depending on data distribution, with a significance level set at p < 0.05. Digital model superimposition based on posterior maxillary reference landmarks was used to visualize morphological changes over time. Significant changes were observed in both the transverse and sagittal dimensions. The anterior cleft width decreased significantly (mean difference = − 0.95 mm, p = 0.001), whereas the anterior and posterior arch widths increased (mean difference = 1.81 mm and 0.99 mm, respectively). The lengths of both the greater and lesser segments increased significantly, and a medial rotation of the greater segment was noted. However, no significant changes were observed in the vertical dimension. Superimposition of the digital models demonstrated notable medial movement of the greater segment and narrowing of the alveolar cleft gap. This study provides preliminary data on early morphological changes in the maxillary arch following modified NAM and cheiloplasty in infants with UCLP. Although no control group was included, three-dimensional assessment revealed favorable growth patterns in the transverse and sagittal dimensions. Further prospective studies with control comparisons are recommended to confirm these findings.
Pattanawasin et al. (Wed,) studied this question.