Nasoalveolar Molding with Active Columellar Lengthening in Severe Bilateral Cleft Lip/Palate: A Clinical Report


  • Previously presented at the Indian Prosthodontic Society's 9th ‘Post-Graduate Student Convention,’ Wardha, Maharashtra, India; June 2007.

  • The authors deny any conflicts of interest.

Pravinkumar G. Patil, Department of Prosthodontics, Room no. 121, Govt. Dental College & Hospital, GMC Campus, Nagpur, Maharashtra 440003, India. E-mail:


Severe bilateral cleft-lip/palate patients are difficult to manage even if nasoalveolar molding therapy is advocated before surgical repair. A 5-day-old male infant with bilateral cleft-lip-palate was managed with the nasoalveolar molding technique. Periodic adjustments of the appliance were continued every week to mold the nasoalveolar complex into the desired shape for the 5 months of infancy. The cleft width of 12 mm on the right and 14 mm on the left side was completely reduced, and the absent columella was lengthened to 6 mm with the active molding appliance. The horizontal bar of the nasal stent of the appliance was modified by adding an additional 1 mm layer of resilient liner on the tissue surface to achieve rapid columellar lengthening. In severe bilateral cleft-lip/palate cases, simple modifications in the appliance can achieve rapid results.