The Effect of Presurgical Nasoalveolar Molding (PNAM) in Cleft Lip And Palate

Muhammad Aqeel, Jawad Asghar, Zaeem Zafar

Abstract


Purpose: To compare the bacterial flora in patients with cleft lip and palate (CLP) following presurgical nasoalveolar molding appliance (PNAM) therapy to (1) their pre-appliance flora, (2) the flora of their primary care provider, and (3) the flora of a healthy infant control patient population.

Materials & Methods: This is a case control blinded study of patients undergoing PNAM therapy at the UTHealth Post Doctorate Program in Pediatric Dentistry clinic aged birth to 6 months. The control patient population was derived from the UTHealth Physicians General Pediatric Clinic. Primary care providers were sampled at the initial visit only. Samples were obtained from the cleft group on the date of delivery of the appliance and the last visit prior to cheiloplasty. In the control infant group, the samples were obtained at their two-week well child check-up and four-month well child check- up. DNA was extracted from all samples and 16s rRNA gene sequencing was performed to identify the bacteria present in the sample. A differential abundance analysis was conducted to compare the difference in bacterial levels with a false discovery rate (FDR) corrected p-value of < 0.05 being significant.

Results: A total of six CLP patient-parent dyads were recruited for this study. Samples sites for the six parents and CLP patients were collected at the baseline. One hundred and seventy nine samples were collected and analyzed from the 12 dyads. Comparison of the collective infant group versus adult group revealed 918 operational taxonimic units (OTU’s) identified with 390 OTU’s (43%) noted to be significantly different.


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References


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