Complications and solutions in presurgical nasoalveolar molding therapy.
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.
Levy-Bercowski
Daniel
D
Orthodontic Department and Medical College of Georgia Craniofacial Center, Augusta, 30912-1230, USA. dbercowski@mcg.edu
Abreu
Amara
A
DeLeon
Eladio
E
Looney
Stephen
S
Stockstill
John
J
Weiler
Michael
M
Santiago
Pedro E
PE
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