A Comparison of a Novel Passive Nasoalveolar Molding Technique Versus Traditional Active Molding for Alveolar Cleft Reduction

Objective We developed a hybrid technique, termed passive nasoalveolar molding (PNAM). The primary objective of this study is to compare the efficacy of PNAM to the established Grayson technique for nasoalveolar molding (NAM) in reducing the alveolar cleft in patients with clefts involving the lip and primary palate. Design This was a single-institution retrospective study. Setting One senior orthodontist performed traditional NAM, and another senior orthodontist performed PNAM. Patients, Participants All patients with cleft of the lip and primary palate who underwent these procedures between April 2019 and April 2022; n = 11 for NAM and n = 16 for PNAM. Main Outcome Measures For each patient, 3D digital models were analyzed at 2 time points: prior to treatment initiation and following primary palatal closure. Changes in interalveolar width, maxillary width, and canine position were compared using 2-tailed independent t -tests. Results There were no statistically significant differences between the PNAM and NAM groups. The mean reduction in interalveolar segment distance was 10.19 mm for the PNAM group and 8.32 mm for the NAM group ( P = .258). Similarly, the mean change in canine distance was 2.89 mm and 1.74 mm, respectively ( P = .410), and the mean change in maxillary width was 1.36 mm and 0.79 mm, respectively ( P = .399). Conclusion PNAM achieves comparable alveolar treatment outcomes to traditional NAM while offering advantages in reduced cost and fewer required appointments. By reducing financial and logistical burdens, PNAM may improve access to care in the management of cleft lip and palate.