A Point-of-Care Digital Workflow for 3D Printed Passive Presurgical Orthopedic Plates in Cleft Care

Abstract

Cleft lip and palate are one of the most common congenital craniofacial malformations. As an initial treatment, presurgical orthopedics is considered standard treatment at many cleft centers. Digital impressions are becoming feasible in cleft care. Computer-aided design (CAD) and three-dimensional (3D) printing are manufacturing standards in dentistry. The assimilation of these technologies has the potential to alter the traditional workflow for the fabrication of customized presurgical orthopedic plates. We present a digital workflow comprising three steps: 3D digital image acquisition with an intraoral scanner, open-source CAD modeling, and point-of-care 3D printing for the fabrication of personalized passive presurgical plates for newborns with cleft lip and palate. The digital workflow resulted in patient-related benefits, such as no risk of airway obstruction with quicker data acquisition (range 1–2.5 min). Throughput time was higher in the digital workflow 260–350 min compared to 135 min in the conventional workflow. The manual and personal intervention time was reduced from 135 min to 60 min. We show a clinically useful digital workflow for presurgical plates in cleft treatment. Once care providers overcome procurement costs, digital impressions, and point-of-care 3D printing will simplify these workflows and have the potential to become standard for cleft care.

Métodos de obtención de modelos de trabajo o estudio de niños con labio y paladar fissurado: Una revisión sistemática

“…Después de la selección de los 25 artículos para la revisión narrativa, esta información obtenida se ha clasificado en estudios de cohorte 20%, de revisión sistemática el 4%, estudio de cohorte transversal 20%, estudió observacional 4%, reporte de caso 8%, articulo original 36%, estudio comparativo 4%, ensayo clínico 4%, como se describe en la Figura 2. El proceso de búsqueda y selección de artículos científicos para la revisión sistemática de métodos de obtención de modelos de trabajo o estudio de niños con labio y paladar fisurado Después de la selección de los 25 artículos para la revisión narrativa, esta información obtenida se ha clasificado en estudios de cohorte (Azhari et al, 2021;Dalessandri et al, 2019;Pillai et al, 2021;Thurzo et al, 2022;Zarean et al, 2022), de revisión de literatura el 4% (Shujaat et al, 2022), estudio de cohorte transversal 20% (Burcu Nur Yılmaz et al, 2019;Fomenko et al, 2019;Passucci Ambrosio Eloá Cristina, 2021), estudió observacional 4% (Asquith & McIntyre, 2012), reporte de caso 8% (Jamayet et al, 2018;Krey K.F, 2018), articulo original 8% (Chalmers et al, 2016;El-Ashmawi et al, 2022;Martin et al, 2015;Okazaki et al, 2022;Patel et al, 2019;Ritschl et al, 2018;Salazar-Gamarra et al, 2016;Xepapadeas et al, 2020;Zeidan & Kamiloğlu, 2021), estudio comparativo 4% (Zhu et al, 2016), ensayo clínico 4%(R. R. Kalaskar & Kk, 2021).…”

Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department

“…If the decision is made in favor of a POCML, it is mandatory to define the workflow and response capacity [ 12 , 45 ], as well as a product portfolio based on experience. Adapting a workflow to the resources of each organization can be the key factor in the success of the implementation [ 46 , 47 ]. Quantifying the error that can be assumed in the process [ 35 , 48 ] is important for clinical security, so it is essential to define all these “artisanal processes” in SOPs for each type of application, following the recommendations of local regulations (in our case, UNE-EN-ISO13485).…”

Proposal of a hybrid workflow to create a device treating the nutritional disability of an infant with cleft lip and palate: Case report

“…Some authors have used a fully digital workflow, from impression-taking to 3D printing of the device for the early treatment of a patient CLP affected. 16 To the best of our knowledge, this is the first study to evaluate the effectiveness of a hybrid workflow that allows the advantages of both digital and analog techniques to be exploited in the fabrication of a device that enables the nutrition of a newborn CLP affected.…”

“…15 Conventional impression-taking in neonates is a procedure that involves risks and complications, such as foreign body detachment, aspiration, and more drastically, airway obstruction. [16][17][18][19] The continuous development of technologies makes it possible to take dental arch impressions, through intraoral scanners, and exclude related risk factors. 20,21 The aim of this clinical study was to create thermoformed devices in Polyethylene, through an innovative hybridized workflow, for the early treatment of the child with cleft lip-palate to enable independent nutrition and thus allowing physiological growth.…”

“…Conventional impression‐taking in neonates is a procedure that involves risks and complications, such as foreign body detachment, aspiration, and more drastically, airway obstruction 16–19 …”