Presurgical Nasoalveolar Molding for Cleft Lip and Palate

Shen, Congcong; Yao, Caroline A.; Magee, William P.; Chai, Gang; Zhang, Yan

doi:10.1097/prs.0000000000001286

Cited by 48 publications

(43 citation statements)

References 26 publications

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“…An example that takes advantage of the power of CAD in 3D printing is the use of patient-specific maxillary models that were digitally designed to predict the molding stages in the treatment of children with cleft lip and palate. The predicted anatomy was 3D printed and used to design appliances for presurgical nasoalveolar molding of the cleft lip and plate (99).…”

Section: Anatomic Models: Pre-surgical Manipulation and Selection Of mentioning

confidence: 99%

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

et al. 2016

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Three dimensional (3D) printing involves a number of additive manufacturing techniques that are used to build structures from the ground up. This technology has been adapted to a wide range of surgical applications at an impressive rate. It has been used to print patient-specific anatomic models, implants, prosthetics, external fixators, splints, surgical instrumentation, and surgical cutting guides. The profound utility of this technology in surgery explains the exponential growth. It is important to learn how 3D printing has been used in surgery and how to potentially apply this technology. PubMed was searched for studies that addressed the clinical application of 3D printing in all surgical fields, yielding 442 results. Data was manually extracted from the 168 included studies. We found an exponential increase in studies addressing surgical applications for 3D printing since 2011, with the largest growth in craniofacial, oromaxillofacial, and cardiothoracic specialties. The pertinent considerations for getting started with 3D printing were identified and are discussed, including, software, printing techniques, printing materials, sterilization of printing materials, and cost and time requirements. Also, the diverse and increasing applications of 3D printing were recorded and are discussed. There is large array of potential applications for 3D printing. Decreasing cost and increasing ease of use are making this technology more available. Incorporating 3D printing into a surgical practice can be a rewarding process that yields impressive results.

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Section: Anatomic Models: Pre-surgical Manipulation and Selection Of mentioning

confidence: 99%

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

et al. 2016

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“…Among the included studies, the one introducing three-dimensional technology report that NAM using three-dimensional technology has the potential to further decrease the cost of treatment by reducing the clinical chair time and the cost of NAM appliance [ 53,54 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the studies that evaluated CAM system, one prospective study and one randomized control trial were selected [ 53 , 64 ]. Both showed that this method is a more efficient, more precise and more predictable technology.…”

Section: Resultsmentioning

confidence: 99%

Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review

Maillard

Retrouvey

Ahmed

et al. 2017

JOMR

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ObjectivesThe authors performed a systematic review to evaluate the potential beneficial effects of the nasoalveolar molding appliance on nonsyndromic unilateral clefts of the lip and/or palate prior to primary lip repair.Material and MethodsA literature search was performed using three electronic databases (PubMed, Embase, Web of Science) and three journals (“Cleft Palate-Craniofacial Journal”, “Plastic and Reconstructive Surgery Journal” and “American Journal of Orthodontics and Dentofacial Orthopaedic”) from January 1980 to April 2017. Data extraction was performed with tables treating different subjects: surgical, aesthetical, functional, socio-economical effects of nasoalveolar molding (NAM) appliances and the evolution of NAM appliances, especially three-dimensional technology.ResultsOf the 145 articles retrieved in the literature surveys, 28 were qualified for the final analysis and 20 studies were excluded because of their small sample size (less than 10 patients) and/or too long follow-up (exceeded 18 months). Four randomized controlled trials were available. Although literature allowed discussing the short-term benefits of NAM appliance and the three-dimensional technology, scientific evidence is lacking.ConclusionsBased on the results, nasoalveolar molding appliances have positive surgical, aesthetical, functional and socio-economical effects on unilateral clefts of the lip and/or palate treatment before the primary repair surgeries. Three-dimensional technology results in a more efficient and predictable nasoalveolar molding appliance treatment. However, nasoalveolar molding appliance effect in a short term remains unclear with the available literature. Further studies that integrate three-dimensional technology in a large scale are still needed.

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“…The cost of a medium quality IOS, ranging from 15000 to 30000 EUR, is surely not comparable with the pure cost of classical impression materials and trays used during a T&P protocol, but, considering that the use of IOS diffusion is rapidly increasing because they can be used in several fields, the cost-per-single use is gradually decreasing, in direct proportion with use. Furthermore, digitally simulating progressive changes in cleft anatomy make it possible to prepare the entire set of molding plates in advance, reducing the need for frequent visits for plate adjustments [53,54]. Nevertheless, the intraoral scanning process, with no risk of impression material inhalation, can be performed without patient transportation to the dental clinic, if a portable IOS is used.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study

et al. 2019

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The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients were divided, according to impression technique used, into a digital (intraoral scanner (IOS)) and a non-digital (tray and putty (T&P)) group. Parents considered IOS impressions to be less invasive, compared to T&P impressions. The clinician that took all the impressions considered the IOS to be less stressful compared to the T&P method. In two T&P patients, the impression was repeated because some important anatomical details were missing, in one case due to patient regurgitation during the first attempt. No impression was repeated, and any adverse event was reported in the IOS group. There were no significant differences between these two protocols in pre-surgical alveolar gap reduction and surgical challenge. The study results indicate that this digital protocol can accelerate the production process of the passive molding plate with an instantaneous transmission of the digital impression to the dental lab, maintaining the same accuracy level and clinical outcomes of classical techniques and reducing the invasiveness of impression taking, avoiding any risk of impression material ingestion or inhalation.

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Presurgical Nasoalveolar Molding for Cleft Lip and Palate

Abstract: Therapeutic, IV.

Cited by 48 publications

References 26 publications

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

Correlation between Nasoalveolar Molding and Surgical, Aesthetic, Functional and Socioeconomic Outcomes Following Primary Repair Surgery: a Systematic Review

Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study

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