Treatment with nasoalveolar modeler in a child with bilateral transforamen cleft through reverse engineering: case report

Cleft lip and palate are common and highly complex congenital malformations that require early and multidisciplinary interventions to ensure satisfactory functional and aesthetic outcomes. This case report describes an infant with a bilateral transforaminal cleft lip and palate treated with the Nasoalveolar Molding protocol starting at 14 days of life as preparation for primary surgery. The treatment involved the fabrication of customized orthopedic plates using reverse engineering technology, along with the concurrent use of a nasal elevator and lip tape. After seven weeks, there was a significant reduction in the alveolar cleft width and nasal remodeling, resulting in improved symmetry and favorable anatomical conditions for cheiloplasty and palatoplasty surgeries. Continuation of the protocol through the postoperative period demonstrated important aesthetic and functional gains, reflecting the effectiveness of Nasoalveolar Molding in the presurgical management of complex cleft lip and palate cases. This case highlights the importance of individualized follow-up, family commitment, and the integrated work of a multidisciplinary team for therapeutic success, contributing to an improved quality of life for the patient.