Effects of Presurgical Functional Orthopedics in Children with Cleft Lip and Palate
Keywords:
cleft lip and palate; orthopedic plate; cleft closure.Abstract
Introduction: Cleft lip and palate are congenital anomalies caused by the failure of fusion of the embryonic facial processes. Their treatment requires early intervention through presurgical orthopedics, which favors cleft closure by approximating the alveolar segments, facilitates surgical treatment, and contributes to the child’s functional development, particularly in feeding, growth, and early adaptation, highlighting its importance from a comprehensive pediatric perspective.
Objective: To determine the effects of presurgical orthopedic plates on the passive closure of cleft lip and palate in children with this malformation.
Methods: A retrospective-prospective longitudinal observational study was conducted at the José Luis Miranda University Pediatric Hospital of Villa Clara between March 2019 and June 2021. The sample consisted of 34 children, with prior informed consent from their parents. Information was obtained through interviews, clinical examination, and measurement of study models. Statistical tests such as the Wilcoxon test and Fisher’s exact test were applied.
Results: Male sex and left unilateral cleft predominated. With the use of the presurgical orthopedic plate, a mean reduction of 8.4 mm in the anterior margin and 7.8 mm in the posterior margin of the cleft was observed.
Conclusions: Presurgical orthopedics favors cleft closure, with beneficial effects both for surgical therapy and for the child’s functional development from a comprehensive pediatric perspective.
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1. Putri FA, Pattamatta M, Anita SES, Maulina T. The global occurrences of cleft lip and palate in pediatric patients and their association with demographic factors: a narrative Review. Children (Basel). 2024 [acceso 23/03/2026];11(3):322. Disponible en: https://www.mdpi.com/2227-9067/11/3/322
2. Alaviyan AH. Cleft Lip and Palate: Overview of causes, surgical repair, and treatment approaches: a narrative review. World J Plast Surg. 2025 [acceso 23/03/2026];14(3):3-8. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12843004/
3. Kini U. Genetics and orofacial clefts: a clinical perspective. Br Dent J. 2023 [acceso 23/03/2026];234(12):947-52. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10287552/
4. Budner M, Korulczyk P, Lasota A. Etiology of cleft lip and/or cleft palate in Southeastern Poland based on current observational study. J Clin Med. 2025 [acceso 23/03/2026];14(16):5682. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12386728/
5. Shaik N, Eggula A, Pudi S, Yemineni BC, Jagati S, Cheduravally TR. Presurgical orthopedic nasoalveolar molding in cleft lip and cleft palate: Case report. Int J Clin Pediatr Dent. 2023 [acceso 20/03/2026];16(4):659-62. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10507294/
6. Abdelnaeem Ahmed AF, Fathy A, Santiago Alicea PE, Taha A, Bestway A. Presurgical nasoalveolar molding in unilateral cleft lip and palate: Evaluating alveolar approximation and maxillary arch changes with GS-NAM versus conventional NAM technique. Bulletin of Stomatology and Maxillofacial Surgery. 2026 [acceso 20/03/2026];22(1)3-11. Disponible en: https://stomatology-mfsjournal.com/wp-content/uploads/2026/01/Presurgical-Nasoalveolar-Molding-in-Unilateral-Cleft-Lip-and-Palate-Evaluating-Alveolar-Approximation-and-Maxillary- Arch-Changes-with-GS-NAM-Versus-Conventional-NAM-Technique-1-1.pdf
7. Navas Aparicio MC. Crecimiento maxilar según severidad de hendidura labial, alveolar y palatina unilateral. Cir Plást Iberolatinoam. 2012 [acceso 21/03/2026];38(4):349-57. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922012000400006&lng=es
8. Rossell Perry P, Cotrina Rabanal O, Cáceres Nano E. Nuevo enfoque en el tratamiento quirúrgico de las fisuras palatinas congénitas. Cir Plást Iberolatinoam. 2015 [acceso 21/03/2026];41(4):409-17. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922015000400008&lng=es
9. World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013;310(20):1-95. DOI: https://doi.org/10.1001/jama.2013.281053
10. Heydari MH, Sadeghian A, Khadivi G, Mustafa HJ, Javinani A, Nadjmi N, et al. Prevalence, trend, and associated risk factors for cleft lip with/without cleft palate: a national study on live births from 2016 to 2021. BMC Oral Health. 2024 [acceso 21/03/2026];24(1):36. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10771673/
11. Sundoro A, Hilmanto D, Soedjana H, Lesmana R, Harianti S. Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review. Arch Craniofac Surg. 2024 [acceso 21/03/2026];25(2):62-70. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC11098759/
12. España-Guerrero A, España-Guerrero E, Liceras-Liceras E, Bullejos-Martínez E, Martínez-Plaza A, Alaminos M, et al. Evaluating the effectiveness of nasoalveolar molding in the management of children with unilateral cleft lip and palate: A Cohort Study. Dent J (Basel). 2025 [acceso 21/03/2026];13(9):394. Disponible en: https://pubmed.ncbi.nlm.nih.gov/41002666/
13. Ali AA. A comprehensive clinical perspective of nasoalveolar molding (NAM) for the treatment of cleft lip and palate patients. J Clin Exp Dent. 2025 [acceso 21/03/2026];17(5):e552-e559. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12142368/
14. Frazao DC, Salgado MAC, Cody RJ, Kay EM, Pretti H, Singh GD, et al. Expanding access to presurgical cleft care: digital nasoalveolar molding with clear aligners in a rural low-income population. Children (Basel). 2025 [acceso 21/03/2026];12(9):1231. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12468677/
15. Martínez-Orellana A, Camañes-Gonzalvo S, Tejero-Martínez A, Salom-Alonso L, Bellot-Arcís C, García-Sanz V, et al. Perception, attitude, and opinion of parents of cleft lip and palate patients treated with nasoalveolar molding (NAM): A cross-sectional questionnaire study. Int J Paediatr Dent. 2025 [acceso 21/03/2026];35(4):698-707. Disponible en: https://pubmed.ncbi.nlm.nih.gov/39456118/
16. Albustani SH, Dziedzic A, Abid M. The perception and experience of parents of children with cleft lip and palate concerning the use pre-surgical infant orthopedics: A questionnaire-based cross-sectional survey. Children. 2022 [acceso 21/03/2026];9(7):1054. Disponible en: https://www.mdpi.com/2227-9067/9/7/1054
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