Workshop in the Grayson-Santiago NasoAlveolar Molding (NAM) Device and Technique for Cleft Lip and Palate

Duke University Workshop in Presurgical Infant Orthopedics and Orthodontic Treatment for Patients with Clefts of the Lip and Palate: From Birth to Mixed Dentition

April 30 & May 1, 2023

May 6 & 7, 2023

DDS Education Center
3514 University Dr. 
Suite 500
Durham, NC 27707

NAM Course Director

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

Visiting Professor

Barry H. Grayson, DDS
Division of Plastic Surgery
Duke University

NAM Course Objectives

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 the Grayson-Santiago NasoAlveolar Molding 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
  • Describe the orthopedic and orthodontic maxillary arch preparation for a secondary alveolar bone graft procedure
  • Describe the indications and biomechanics for maxillary protraction (face mask therapy)
  • Describe the objectives and biomechanics for limited orthodontic treatment in the mixed dentition 

NAM Course Agenda

Day one: Full day Didactics

  • History and evolution of presurgical orthopedics 
  • Unilateral and Bilateral Cleft Lip and Palate Anatomical Deformity
  • Grayson-Santiago NasoAlveolar Molding Technique Objectives for Unilateral and Bilateral Cleft Lip and Palate
  • Construction, adjustments, and biomechanics of the unilateral and bilateral cleft lip and palate Grayson-Santiago NAM device
  • Orthopedic and orthodontic treatment in mixed dentition 

Day Two: Full day Hands-On

  • Step by Step construction, adjustments, and biomechanics of the unilateral and bilateral cleft lip and palate NAM Device
  • Practice on simulators


Pedro E. Santiago, DMD, MBA

Course Director

Dr. Santiago is the Director of Oral Health and Craniofacial Orthodontics at Duke and a respected international educator 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 with Dr. Grayson to develop the NasoAlveolar Molding technique to its current standards. The Grayson-Santiago NAM device and technique is the presurgical orthopedic technique most used by cleft centers around the globe. 

Barry H. Grayson, DDS 

Visiting Professor

Dr. Grayson is considered one of the pioneers in the field of craniofacial orthodontics. He has held multiple academic positions over the last 40 years and has published over 160 scientific articles and book chapters in cleft lip and palate, craniofacial anomalies, and distraction osteogenesis. In 1995, Dr. Grayson established the first Hospital-based Fellowship training program in Craniofacial Orthodontics at NYU. Dr. Grayson introduced the NasoAlveolar Molding technique for the correction of nasal cartilage deformity prior to primary cleft repair in the early '90s. This has resulted in a globally accepted alternative to the traditional approach to presurgical infant orthopedics.

Jeffrey R. Marcus, MD

Dr. Marcus is the Chief of the Division of Plastic, Maxillofacial, and Oral Surgery in the Department of Surgery, Director of the Cleft and Craniofacial Center, and Director of the Integrated Plastic and Reconstructive Surgery Residency Program at Duke University Medical Center. He is an internationally recognized expert in rhinoplasty, lip and cleft palate, and craniofacial surgery. His clinical interests include functional and cosmetic nasal surgery (rhinoplasty) for adolescents and adults, facial paralysis, plastic surgery of the ear, and the full range of pediatric plastic surgery. He previously served as Chief of Surgery for Duke Children’s Hospital and led the initiative resulting in Duke Children’s becoming one of only five centers in the country initially designated a Level 1 program for children’s surgical care by the American College of Surgeons.

Grayson-Santiago NasoAlveolar Molding (NAM)

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 Grayson- Santiago 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.  


Coming soon!

Please contact Jim Bolognesi at with any questions.


The Washington Duke Inn 
3001 Cameron Blvd Durham, NC 27705

JB Duke
230 Science Drive Durham, NC 27705

AC Marriot
2800 Erwin Road Durham, NC 27705


Please note transportation will be provided to and from the workshop from these hotels only.