title: Complications and solutions in presurgical nasoalveolar molding therapy.
abstract: OBJECTIVE
  To outline three main categories of nasoalveolar molding complications, describe their etiologies and manifestations, and prescribe preventive and palliative therapy for their proper management. Estimates of the incidence of each complication also are provided.
  
  
  METHODS
  Data were collected retrospectively from the charts of 27 patients with complete unilateral cleft lip and palate treated by the first author (D.L.-B.) at the University of Puerto Rico (n = 12) and the Medical College of Georgia (n = 15). Confidence intervals for the true incidence of each complication were calculated using exact methods based on the binomial distribution. A significance level of .05 was used for all statistical tests.
  
  
  RESULTS
  Of the soft and hard tissue complications considered, only one (tissue irritation) had an estimated incidence greater than 10%. Compliance issues were of greater concern, with an estimated incidence of 30% for broken appointments and an estimated incidence of 26% for removal of the nasoalveolar molding appliance by the tongue.
  
  
  CONCLUSIONS
  Although benefits outnumber the complications, it is important to address all complications in order to prevent any deleterious outcomes.
authors.affiliation: Orthodontic Department and Medical College of Georgia Craniofacial Center, Augusta, 30912-1230, USA. dbercowski@mcg.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy-Bercowski
authors.forename: Amara
authors.initials: A
authors.lastname: Abreu
authors.forename: Eladio
authors.initials: E
authors.lastname: DeLeon
authors.forename: Stephen
authors.initials: S
authors.lastname: Looney
authors.forename: John
authors.initials: J
authors.lastname: Stockstill
authors.forename: Michael
authors.initials: M
authors.lastname: Weiler
authors.forename: Pedro E
authors.initials: PE
authors.lastname: Santiago
mesh_terms: D000539:Alveolar Process / Q000473:pathology; D001071:Appointments and Schedules; D002180:Candidiasis, Oral / Q000209:etiology; D002971:Cleft Lip / Q000628:therapy*; D002972:Cleft Palate / Q000628:therapy*; D003877:Dermatitis, Contact / Q000209:etiology; D004844:Epistaxis / Q000209:etiology; D005148:Facial Dermatoses / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055171:Nasal Cartilages / Q000293:injuries; D009297:Nasal Mucosa / Q000473:pathology; D009668:Nose Diseases / Q000209:etiology; D019226:Oral Ulcer / Q000209:etiology; D010158:Palatal Obturators / Q000009:adverse effects*; D010349:Patient Compliance; D011474:Prosthesis Design / Q000009:adverse effects*; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D014456:Ulcer / Q000209:etiology