International Workshop in NasoAlveolar Molding (NAM) for Cleft Lip and Palate

Pedro E. Santiago, DMD, MBA
Director, Duke Oral Health
Director, Duke Craniofacial Orthodontics

The participants will be able to: 

• Understand and describe the nasal, labial, and alveolar anatomical deformities associated with unilateral and bilateral cleft lip and palate. 
• Describe the objectives for NasoAlveolar Molding (NAM) therapy in unilateral and bilateral cases.
• Construct and adjust a NAM appliance for patients with unilateral and bilateral cleft lip and palate.
• Define the biomechanical principles that distinguish between making changes in shape and position of cleft alveolar segments. 
• Describe the biomechanics underlying molding of the deformed nose and alveolar processes. 
• Assemble an elastic/taping system to achieve effective operation of the NAM appliance. 
• List the most common complications associated with NAM along with the most effective ways to prevent them from occurring.

Day One: Half-Day

• Unilateral and bilateral cleft lip and palate anatomical deformity
• NasoAlveolar Molding (NAM) technique for unilateral and bilateral cleft lip and palate
• Biomechanics of the NAM appliance
• Complications and solutions

Day Two: Half-Day “Hands-On”

• Construction, adjustments, and biomechanics of the unilateral and bilateral cleft lip and palate NAM appliance
• Assembly, activation, and adjustments of the elastics/tapes system
• Questions and answers

Pedro E. Santiago, DMD, MBA

Dr. Santiago is the Director of Oral Health and Craniofacial Orthodontics at Duke and a respected international educator and innovator in the field of craniofacial orthodontics. In 1995, he was accepted as the first craniofacial orthodontic fellow at the New York University Medical Center under the mentorship of Dr. Barry Grayson. Dr. Santiago was the founder, professor and director of the Orthodontic Graduate Program and the Center for Craniofacial Disorders at the University of Puerto Rico from 1996-2008. He is an international speaker and has published many scientific articles and book chapters in international orthodontic and surgical journals. Dr. Santiago contributed to develop the NasoAlveolar Molding (NAM) technique to its current standards.

Cleft lip and palate deformities have a significant esthetic impact on the face and affects the psychosocial development of the patient. Traditional presurgical infant orthopedic treatment and the primary surgical repair focus on the alveolar and labial deformity, placing little emphasis on the nasal deformity. In this course, we describe the NasoAlveolar Molding (NAM) technique for patients born with unilateral and bilateral cleft lip and palate, which attempts to reduce the severity of the nasal, labial and alveolar deformities in order to enhance the outcome of the primary surgical repair. Patients that have undergone presurgical NasoAlveolar Molding therapy and primary lip and nose repair have gone on to demonstrate superior facial esthetics, symmetry and growth of the nasolabial complex compared to children treated with conventional methods. It has been shown that the incorporation of NAM into the presurgical treatment protocol has reduced the need for multiple revision surgeries.