Presurgical Infant Orthopedics for Cleft Lip and Palate: A Review

Abstract

Cleft lip and palate deformities are some of the most common facial and oral anomalies. Severe cleft forms are associated with severe nasolabial deformities, and present a significant surgical challenge in order to achieve a functional and aesthetic outcome. Presurgical infant orthopedics has been used in the treatment of cleft lip and palate for some centuries. Starting with the McNeil method, several methods and modifications had been developed by different clinicians over time. However, there is no consensus in the literature on infant orthopedic methods and their benefits. Therefore, the aim of this review is to discuss presurgical infant orthopedic methods and their advantages and disadvantages. Presurgical orthopedics allows not only the alignment of cleft segments, but also molding alar cartilages and nose tip. In addition, this procedure allows performing primary alveolar grafting or gingivoperiosteoplasty to establish a union bone at the cleft side as well. However, there have been some studies reporting that there was no positive effect of presurgical orthopedics on the maxilla and maxillary arch. There is still no consensus in the literature on the best protocol for orthopedic and surgery methods for the treatment of cleft lip and palate in infants.