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

Two separate sessions are available: 

Introductory Course

March 7 – 8, 2025

Entry-level hands-on course for healthcare providers and laboratory technicians interested in learning the GS-NAM technique and its applications

Cost: $2,995

Master Course

March 15, 2025 – virtual course

Advanced course for experienced GS-NAM providers interested in refreshing the technique’s goals and biomechanics and its applications in complex case scenarios. Participants are encouraged to present one unilateral and one bilateral case treated with NAM. 

Cost: $1,495 

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

Pedro E. Santiago, DMD, MBA
Director, Duke Oral Health
Co-director, Duke Cleft and Craniofacial Team

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

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.

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

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

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.
• 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: Didactics and Hands-on 

• Review of the Unilateral and Bilateral Cleft Lip and Palate Nasolabial Deformity
• Grayson-Santiago NasoAlveolar Molding (GS-NAM) Technique Objectives for Unilateral and Bilateral Cleft Lip and Palate
• Construction, adjustments, and biomechanics of the unilateral and bilateral cleft lip and palate GS-NAM device
• Case presentations and discussion of complex cases by faculty and participants

Pedro E. Santiago, DMD, MBA

Course Director

Dr. Santiago is the Director of Duke Craniofacial Orthodontics, Co-director of the Duke Cleft and Craniofacial Team 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.

Daniel Levy-Bercowski, DDS, MS, MSD

Dr. Levy is a board-certified orthodontist working as associate clinical faculty at the Department of Surgery, Plastic, Maxillofacial, and Oral Surgery at Duke University. He came from Augusta, GA, where he worked as a professor in the Department of Orthodontics, Dental College of Georgia at Augusta University for 17 years. He was also the co-director of the AU Craniofacial Center. Dr Levy obtained a DDS and Master of Science in Pediatric Dentistry in Venezuela. In addition, he obtained a Master of Dental Sciences and a Certificate in Orthodontics at the University of Puerto Rico. He completed a year of additional training in managing cleft lip and palate patients, including pre-surgical nasoalveolar molding. Dr. Levy is actively involved in publications and research related to orthodontics, pediatric dentistry, and cleft lip and palate diagnosis and management.

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, cleft lip and 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.

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 (GS-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.

Introductory Course

Register
 
Master Course

Register

Please contact Tina B. Blackwell at tina.berry@duke.edu with any questions.

The Washington Duke Inn 
3001 Cameron Blvd Durham, NC 27705
919-490-0999

JB Duke
230 Science Drive Durham, NC 27705
919-660-6400

AC Marriot
2800 Erwin Road Durham, NC 27705
984-900-2700

Smile Together is proud to sponsor this event and the education of this and future generations of cleft and craniofacial providers.