Influence of Presurgical Orthodontic Molding on the Growth of Newborns With Unilateral Cleft Lip Palate

NCT ID: NCT05081258

Last Updated: 2022-05-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-01

Study Completion Date

2026-11-01

Brief Summary

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Orofacial clefts are the second most common birth deformity and vary in etiology and phenotype, e.g. isolated cleft palate, cleft lip or cleft lip palate. Especially newborns with unilateral complete cleft lip and palate (UCLP) present severe facial asymmetries auch as a broad and flat ala of the nose, a deviation of the columella and the philtrum to the non cleft side. Since postnatal asymmetries can even remain after surgical lip closure in a alleviated shape, therapeutic presurgical orthodontic approaches to improve symmetrie of the nose and to achieve ideal conditions for lip surgery are essential.

Presurgical orthodontic treatment for newborns with UCLP start within the first days after birth to separate oral and nasal cavitiy, to improve breathing and feeding and to regulate growth of the maxillary segments using passive appliances (passive Alveolar Molding (pAM)). An advanced and widely spread concept is the Nasoalveolar Molding (NAM) by Grayson, which was first introduced in 1993 as a palate plate combined with a nasal stent as a non-invasive presurgical appliance to stimulate growth of the nose and use the postnatal potential to modulate the nasal cartilage. The aim of the NAM therapy is to reduce nasal width, to reduce deviation of the columella to the non cleft side and to increase nostril height. However, due to inhomogeneous study designs and results, so far only a slightly positive effect using NAM therapy could be detected and prospective, randomized clinical trials are necessary.

The aim of the study is to analyse and to compare the effects of pAM versus NAM treatment in newborns with UCLP in the first year of life. The following parameters will be analysed on defined study time points: nostril width, nasal morphology, cleft width, maxillary growth, statical and dynamical facial asymmetries and facial perception.

Detailed Description

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Conditions

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Cleft Lip and Palate Unilateral Cleft Lip

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

prospective, longitudinal, randomized, clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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NAM treatment

Study Group: newborns with UCLP will be treated with a palate plate with nasal stent (Nasoalveolar Molding = NAM)

Group Type ACTIVE_COMPARATOR

Nasoalveolar Molding

Intervention Type PROCEDURE

A passive palate plate will be inserted within the first week after birth. A nasal stent will be added to the palate plate after one week (NAM appliance). The NAM appliance will be modified on regular appointments and remain until surgical lip closure (6-7 months of life). After surgical lip closure, infants will receive a nostril retainer and will be treated with a passive palate plate without nasal stent until palate closure (10-12 months of life).

pAM treatment

Control Group: newborns with UCLP will be treated with a palate plate without nasal stent (passive Alveolar Molding = pAM)

Group Type SHAM_COMPARATOR

passive Alveolar Molding

Intervention Type PROCEDURE

A passive palate plate (passive Alveolar Molding) will be inserted within the first week after birth. The pAM appliance will be modified on regular appointments and remain until surgical lip closure (6-7 months of life). After surgical lip closure, infants will receive a nostril retainer and the treatment with the pAM appliance will continue until palate closure (10-12 months of life).

Interventions

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passive Alveolar Molding

A passive palate plate (passive Alveolar Molding) will be inserted within the first week after birth. The pAM appliance will be modified on regular appointments and remain until surgical lip closure (6-7 months of life). After surgical lip closure, infants will receive a nostril retainer and the treatment with the pAM appliance will continue until palate closure (10-12 months of life).

Intervention Type PROCEDURE

Nasoalveolar Molding

A passive palate plate will be inserted within the first week after birth. A nasal stent will be added to the palate plate after one week (NAM appliance). The NAM appliance will be modified on regular appointments and remain until surgical lip closure (6-7 months of life). After surgical lip closure, infants will receive a nostril retainer and will be treated with a passive palate plate without nasal stent until palate closure (10-12 months of life).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* newborns/infants with non-syndromal (ns) unilateral cleft lip palate (UCLP)
* signed informed consent by the parents or legal guardian

Exclusion Criteria

* newborns/infants with syndromal (s) unilateral cleft lip palate (UCLP)
* insufficient adherence and compliance by the parents or legal guardian
* withdrawal of informed consent by the parents or legal guardian
Minimum Eligible Age

1 Day

Maximum Eligible Age

2 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Erlangen-Nürnberg

OTHER

Sponsor Role lead

Responsible Party

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Dr. Corinna Lesley Seidel

Orthodontist, Senior Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Corinna Seidel, Dr.

Role: STUDY_DIRECTOR

Department of Orthodontics and Orofacial Orthopedics, University Hospital of Erlangen-Nurnberg

Lina Gölz, Prof. Dr.

Role: STUDY_DIRECTOR

Department of Orthodontics and Orofacial Orthopedics, University Hospital of Erlangen-Nurnberg

Karin Strobel, Dr.

Role: STUDY_DIRECTOR

Department of Orthodontics and Orofacial Orthopedics, University Hospital of Erlangen-Nurnberg

Locations

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Department of Orthodontics and Orofacial Orthopedics, University Hospital of Erlangen-Nurnberg

Erlangen, Bavaria, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Corinna Seidel, Dr.

Role: CONTACT

++49-09131-85-45667

Karin Strobel, Dr.

Role: CONTACT

++ 49-09131 85-33645

Facility Contacts

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Corinna Seidel, Dr.

Role: primary

++49-09131-85-45667

Lina Gölz, Prof. Dr.

Role: backup

++49-09131-85-33643

Other Identifiers

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ER-pAM-NAM-UCLP-RCT

Identifier Type: -

Identifier Source: org_study_id

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