December 2011. A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Introduction: The nasoalveolar molding appliance is used pre-surgically in cleft lip and palate patients as a method of bringing together the lip and alveolus by applying force to direct desired growth.1 It is used in the infant to reduce the pre-surgical severity of the initial cleft and to improve alignment of the base of the nose and lip segments.1 The purpose of this study was to examine the long-term effect of nasoalveolar molding on facial growth and nasolabial esthetics in complete unilateral cleft lip and palate patients. Methods: Sixteen (N=16) post-surgical cleft lip and palate patients who had undergone nasoalveolar molding as infants and twelve (N=12) control patients, treated surgically without nasoalveolar molding, were recalled for a clinical examination including impressions, photographs, and a lateral cephalogram. Dental models were analyzed using the Goslon Yardstick, developed by Mars et al. in 1987.2¬ Photographs were analyzed using the Asher-McDade method for rating the nasolabial appearance in patients with cleft lip and palate.3 Finally, lateral cephalograms were digitized and analyzed using Dolphin Imaging software. Results: Separate ordinal logistic regression models indicated no significant difference between the molding and non-molding groups in Goslon score, nasal form, nose symmetry, vermilion border or nasolabial profile assessments. Generalized linear models revealed one cephalometric variable to be statistically significant between the two groups. The ANB angle was decreased by 2.34 degrees on average in the group who underwent nasoalveolar molding prior to cheiloplasty. Intra-rater and inter-rater weighted kappa statistics were calculated for each variable. Conclusion: Short-term benefits of nasoalveolar molding have been documented in the literature. However, more long-term studies are needed in order to demonstrate the longitudinal effects of the appliance on esthetics and midfacial growth. Due to the limitations of cleft lip and palate studies, it is often difficult to accurately assess treatment effects. Through inter-center studies such as the Eurocleft and Americleft projects, some limitations and biases can be overcome in order to compare various protocols and outcomes.4 In the future, it is the desire of the investigators to include the current sample of nasoalveolar molding patients in the future efforts and expansion of the Americleft study.