NAM devices are used preoperatively to achieve which outcome?

• A. Promote rapid bone growth after birth.
• B. Gently mold and align maxillary segments before surgery, reducing tissue tension and improving surgical outcomes.
• C. Permanently close cleft without surgery.
• D. Replace need for postoperative orthodontics.

Answer: (B)

Nasoalveolar molding (NAM) is a presurgical orthopedic approach that guides growth and shaping of the upper jaw and nasal structures before repair. The goal is to gently mold and align the maxillary segments and contour the nasal cartilage so the cleft is narrower and the tissues come together with less tension during surgery. When the segments are brought closer and the nose is shaped, the lip and palate repair can be performed under improved conditions, often yielding better symmetry, a more favorable scar, and easier closure.

This technique is started in early infancy and requires ongoing adjustments, usually weekly, with close involvement from the surgical and orthodontic team and the family. It does not permanently close the cleft without subsequent surgery, nor does it replace the need for postoperative orthodontics. It also isn’t about promoting rapid bone growth; the advantage lies in positioning and shaping tissues to optimize the surgical outcome.