throughout the PNAM process.The main goal of the treatment was to stimulate and redirect alveolar growth, intending to achieve a nonsurgical closure of the cleft deformity. MethodsThe primary impression of the cleft defect was made with an ice cream stick and polyvinyl siloxane elastomeric impression IntroductIonCleft lip and palate (CLAP) are frequently observed congenital deformities in the craniofacial region, giving rise to a range of dental abnormalities during the initial phases of life. 1 In addition to dental issues, infants with clefts encounter challenges in breastfeeding due to factors like nasal regurgitation, inadequate oral seal, speech and articulation problems, and difficulties in swallowing. 2 Early intervention and ongoing treatment can address the dental and facial issues associated with CLAP.Surgical management of CLAP dates back to AD 317, when Chinese General Wei Yang-Chi underwent correction through edge trimming and stitching. 3t was later proposed that CLAP cases could be treated or reduced in size nonsurgically due to bone plasticity within the first 3-4 months after birth. 4In 1988, Grayson and Cutting merged presurgical orthopedics with cleft lip and nasal deformity management, pioneering the technique known as presurgical nasoalveolar molding (PNAM). 5PNAM primarily aims to reduce soft tissue and cartilaginous deformities, creating optimal conditions for surgical soft tissue repair with minimal tension to reduce scar formation. 6e hereby present a series of five cases where we attempted to fulfill the objectives of PNAM and improve the alveolar ridge alignment, thus reducing the distance between cleft segments, nonsurgically elongating the columella, and restoring symmetry of the distorted nasal cartilage structure. case descrIptIonsAll 5 patients, aged 28, 8, 15, 9, and 10 days respectively, were referred to the Department of Plastic Surgery with the presentation of CLAP and complaints of difficulty in feeding or regurgitation of milk.Following a comprehensive assessment, the patients were recommended for PNAM followed by repair of the cleft.The parents received extensive counseling about this procedure, its duration, and the expected prognosis of the treatment.Furthermore, they were informed about the importance of their active participation
Shakti et al. (Fri,) studied this question.