Latham and Nasal Molding
Cleft Lip Repair – The objective in repairing the lip is to close the cleft to create a pleasing face that will develop normally with minimal scarring. Closure of the lip is performed by the plastic surgeon when the baby is approximately 3 months of age and weighs at least 10 pounds. When there is involvement of the alveolus and palate, an orthodontic appliance may be placed in the maxillary segments as the first procedure.
This is performed by the team dentist as an outpatient surgical procedure. The appliance is used to align the alveolus so that it can be repaired (gingivoperiosteoplasty) at the time of the lip repair or lip adhesion. This improves nasal support on the cleft side and creates a tunnel that should develop bone, closing the cleft. If the alveolus is not closed in infancy, then the alveolar ridges will be orthodontically aligned and a bone graft performed to stabilize the maxilla (5-10 years of age). Correction of the nasal deformity is usually performed at the time of lip repair. Additional procedures may be necessary to enhance the appearance of either the lip or nose.