Presurgical orthopedics in cleft lip and palate

Child with this anomaly not only suffers for poor dental development but also deprived from breast feeding due to improper oral seal1, swallowing and nasal regurgitation, other associated problems are hearing difficulties due to abnormalities in the palatal musculature, and speech difficulties due to nasal escape and articulation problems. The principle objective of presurgical orthodontics is to reduce the severity of the initial cleft deformity easy breast feeding, swallowing and nasal regulation. Despite the differing opinions about the long-term success of NAM, the immediate success of the therapy facilitates cleft surgery immensely. Although lip closure can always be achieved surgically regardless of the cleft width, preoperative narrowing of the lip and alveolar segments, nasal shaping and columella lengthening help to reduce tissue tension and therefore improve surgical outcome by minimizing wound healing disturbances and scarring. For treatment success, a high compliance and active participation of the patient’s parents is however indispensable.