Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Grill, F; Ritschl, Lucas M.; Dikel, H.; Rau, Andrea; Roth, Maximilian; Eblenkamp, Markus; Wolff, Klaus‐Dietrich; Loeffelbein, Denys J.; Bauer, Franz X.

doi:10.1038/s41598-018-29960-z

Cited by 25 publications

(15 citation statements)

References 26 publications

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“…We wanted to compare the standard geometry to the cross geometry, because automated registration and positioning of the geometry is wanted in a further step in our diagnostics and treatment planning for children with cleft lip and palate. A cross-like geometry has shown best results in this automated step (data not published) and would have been the missing link for fully automated generation of CAD/CAM-assisted appliances for nasoalveolar moulding (NAM) therapy as described earlier [37, 38]. Furthermore, a cross-like geometry seems to be more suitable for the alignment due to definite edges which can be used for reference marker positioning.…”

Section: Discussionmentioning

confidence: 98%

Simultaneous, radiation-free registration of the dentoalveolar position and the face by combining 3D photography with a portable scanner and impression-taking

et al. 2019

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ObjectivesSimultaneous, radiation-free registration of the teeth and the upper and lower jaw positions in relation to the extraoral soft tissue could improve treatment planning and documentation. The purpose of this study is to describe a workflow to solve this form of registration and surface acquisition with a mobile device.MethodsFacial scans of ten healthy participants were taken using a blue-light LED 3D scanner (Artec® Space Spider; Artec® Group; Luxembourg). An impression of the maxillary dentoalveolar arch was taken simultaneously to the 3D photo using a modified impression tray with two different extraoral registration geometries (sphere vs. cross). Following, an impression of the mandibular dentoalveolar arch was taken once. Both impressions were scanned with the 3D scanner. All resulting standard tesselation language (.stl) files of the geometries were compared to the original, virtual .stl files and the root mean square errors (RMSE) were calculated for each surface (Artec Studio 13 Professional × 64; Artec® Group; Luxembourg) to determine which geometry serves as a better reference for intra-extraoral registration.ResultsThe RMSE between the original geometries and the scanned counterfeits were statistically lower for spherical geometries (p < 0.008). Once scanned and aligned, both geometries enabled an alignment of the intra- and extraoral scan. However, the spherical geometries showed virtually better results without significance (p = 0.70).ConclusionsThe presented study provides a radiation-free solution for simultaneous dentoalveolar correlations in relation to the extraoral soft tissue. Spherical geometries achieved more precise and easier intra-extraoral alignments using the applied mobile 3D scanner and workflow.

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Section: Discussionmentioning

confidence: 98%

Simultaneous, radiation-free registration of the dentoalveolar position and the face by combining 3D photography with a portable scanner and impression-taking

et al. 2019

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“…In order to make NAM more available to patients and caregivers, techniques have been developed that target reducing the burden of care of NAM. Several of these techniques such as RapidNAM and computer aided design/computer aided manufacturing (CAD/CAM) technology target reducing the time and number of visits necessary for successful NAM completion (Yu et al, 2013; Bauer et al, 2017; Grill et al, 2018). Much of this new technology continues to be published in case reports until it becomes more readily available (Wang et al, 2013; Subramanian et al, 2016; Premkumar et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

What Is the Burden of Care of Nasoalveolar Molding?

Alfonso

Ramly

Kantar

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: This systematic review aims to evaluate nasoalveolar molding (NAM) in the context of burden of care defined as physical, psychosocial, or financial burden on caregivers. Search Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 5 databases were searched from inception through December 24, 2019, for keywords and subject headings pertaining to cleft lip and/or palate and NAM. Eligibility Criteria: Clinical studies on NAM with reference to physical (access to care, number of visits, distance traveled), psychosocial (caregiver perceptions, family interactions, breast milk feeding), and financial (direct and indirect costs) burden were included. Data Collection and Analysis: Study selection was performed by 2 independent reviewers. Results: The search identified 1107 articles and 114 articles remained for qualitative synthesis. Burden of care domains were discussed but not measured in 43% of articles and only 25% assessed burden of care through a primary outcome. Of these, 20 articles reported on physical, 8 articles on psychosocial, and 12 articles on financial burden. Quality of evidence is limited by study design and risk of bias. Conclusion: Nasoalveolar molding has been indiscriminately associated with burden of care in the literature. Although NAM may not be the ideal treatment option for all patients and families, the physical considerations are limited when accounting for the observed psychosocial advantages. Financial burden appears to be offset, but further research is required. Teams should directly assess the impact of this early intervention on the well-being of caregivers and advance strategies that improve access to care.

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“…The authors did not have the resource nor the technical know-how of 3-D printing metallic nasal stent and a soft liner material as 1 unit. Although some authors have printed only a detachable nasal stent adaptor (Grill et al, 2018b), we fabricated the nasal stent in the laboratory and attached it to the NAM plate.…”

Section: Discussionmentioning

confidence: 99%

A Virtual Noninvasive Way of Constructing a Nasoalveolar Molding Plate for Cleft Babies, Using Intraoral Scanners, CAD, and Prosthetic Milling

Shanbhag¹,

Pandey²,

Mehta

et al. 2019

The Cleft Palate Craniofacial Journal

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Presurgical nasoalveolar molding (PNAM) is a key step in the early management of cleft babies. It involves making an impression of the alveolar segments and the lip elements, after which an appliance is fabricated and activated to achieve optimal alveolar and nasal positions for a superior surgical result. These appliances are fabricated and activated in babies as young as 10 days, and the molding is ideally carried on till the baby is ready for the primary lip repair. This article outlines in detail a digital method of fabricating the PNAM appliance using a combination of intraoral scans, computer-assisted digital software, and computer-assisted machining, facilitated by milling machines. This process obviates impression making and the subsequent laboratory procedures.

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Facilitating CAD/CAM nasoalveolar molding therapy with a novel click-in system for nasal stents ensuring a quick and user-friendly chairside nasal stent exchange

Cited by 25 publications

References 26 publications

Simultaneous, radiation-free registration of the dentoalveolar position and the face by combining 3D photography with a portable scanner and impression-taking

Simultaneous, radiation-free registration of the dentoalveolar position and the face by combining 3D photography with a portable scanner and impression-taking

What Is the Burden of Care of Nasoalveolar Molding?

A Virtual Noninvasive Way of Constructing a Nasoalveolar Molding Plate for Cleft Babies, Using Intraoral Scanners, CAD, and Prosthetic Milling

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