# Early maxillary arch development in unilateral cleft lip and palate: a retrospective 3D morphometric analysis following nasoalveolar molding and cheiloplasty

## TL;DR

This study uses 3D analysis to track maxillary arch development in infants with cleft lip and palate after a specific treatment.

## Contribution

The study introduces a novel 3D morphometric approach to assess early maxillary arch changes following nasoalveolar molding and cheiloplasty in UCLP infants.

## Key findings

- Significant decreases in anterior cleft width and increases in arch widths were observed.
- The greater maxillary segment showed medial rotation and length increase.
- No significant vertical changes were detected in the maxillary arch.

## Abstract

Early assessment of maxillary arch development is crucial in infants with unilateral cleft lip and palate (UCLP). This study aimed to evaluate three-dimensional changes in the maxillary arch following modified nasoalveolar molding (NAM) and cheiloplasty using digital model analysis.

This retrospective study included 25 infants with complete UCLP who underwent modified NAM therapy prior to cheiloplasty. Digital maxillary models were obtained at two time points: T1 on the day of cheiloplasty at 3–6 months of age and T2 on the day of palate repair at 9–18 months of age. Three-dimensional linear and angular measurements were performed to assess transverse, sagittal, and vertical dimensional changes. Changes between T1 and T2 were analyzed using paired t-tests or Wilcoxon signed-rank tests, depending on data distribution, with a significance level set at p < 0.05. Digital model superimposition based on posterior maxillary reference landmarks was used to visualize morphological changes over time.

Significant changes were observed in both the transverse and sagittal dimensions. The anterior cleft width decreased significantly (mean difference = − 0.95 mm, p = 0.001), whereas the anterior and posterior arch widths increased (mean difference = 1.81 mm and 0.99 mm, respectively). The lengths of both the greater and lesser segments increased significantly, and a medial rotation of the greater segment was noted. However, no significant changes were observed in the vertical dimension. Superimposition of the digital models demonstrated notable medial movement of the greater segment and narrowing of the alveolar cleft gap.

This study provides preliminary data on early morphological changes in the maxillary arch following modified NAM and cheiloplasty in infants with UCLP. Although no control group was included, three-dimensional assessment revealed favorable growth patterns in the transverse and sagittal dimensions. Further prospective studies with control comparisons are recommended to confirm these findings.