A comparative evaluation of presurgical infant orthopedics of modified Grayson's technique with clear aligners incorporating a nasal elevator in patients with unilateral cleft lip and palate

Objective: To assess the differences between 2 methods of presurgical infant orthopedics: the modified Gray-son's technique and a new technique using clear aligners in patients with complete unilateral cleft lip and palate. Methods: For this prospective comparative cohort study, 30 patients were divided into 2 groups: group A (modi-fied Grayson technique) and group B (clear aligner trays), with 15 patients each. Scanned cast measurements were taken before and after treatment and evaluated using an appropriate 3-dimensional software assessing treatment changes in the alveolus (eg, reduction of width between major and minor segment, angulation change of each respective segment [intragroup and intergroup, respectively]). This was supplemented with standardized anterioposterior, Worms-eye view, and profile photographs assessing changes in columellar angle, nostril width, height, nasolabial angle, and soft-tissue cleft gap. Furthermore, the number of visits for each patient group was also tabulated and assessed. The differences were compared using the independent t test and Mann-Whitney U test for the respective parameters. Results: Groups A and B showed similar post-treatment changes, with no overt significant differences. However, there was a statistically significant difference in the number of visits (P\0.05), with group B having much lower visits to the center than group A. The posttreat-ment values matched previously established growth reference values. The analysis of photographic measure-ments showed improved nasal asymmetry in both groups without any significant difference. Conclusions: Because there was no difference in the treatment results between the 2 methods and a reduction in the number of required patient visits, presurgical infant orthopedics via clear aligners could pave the way for a more patient-efficient approach.