Intraoral scanning of neonates and infants with craniofacial disorders: feasibility, scanning duration, and clinical experience

Abstract

Summary Objective The aim of this study was to evaluate intraoral scanning (IOS) in infants, neonates, and small children with craniofacial anomalies for its feasibility, scanning duration, and success rate. Impression taking in vulnerable patients can be potentially life-threatening, with the risk of airway obstruction and aspiration of impression material. The advantage of increasingly digitalized dentistry is demonstrated. Materials and methods IOS was captured with the Trios 3® (3Shape, Copenhagen, Denmark) intraoral scanner. The underlying disorders were divided into cleft lip and palate (CLP), Trisomy 21 (T21), Robin Sequence (RS), Treacher Collins syndrome (TC), and isolated mandibular retrognathia (MR). Scan data were analysed by scanning duration, number of images, possible correlations of these factors with the different craniofacial disorders, patient age, and relationship between first and subsequent scans. Clinical experiences with the repeated digital impressions are described. Results Patient data of 141 scans in 83 patients were analysed within an 11-month period. Patients had a median age of 137 days. Median scanning duration was 138 seconds, resulting in a median of 352 images. There was a statistically significant difference in scanning duration (P = 0.001) between infants and neonates. IOS took longest in patients with CLP (537 seconds) and shortest in T21 patients (21 seconds), although there was no statistically significant difference between aetiologies. There was no statistically significant difference between first and subsequent scans in scanning duration. In four cases the IOS had to be repeated, and one patient ultimately required conventional impression taking (all CLP patients; success rate 94%). No severe adverse events occurred. Conclusion IOS is a fast, safe, and feasible procedure for neonates, small children, and infants with craniofacial malformations. One special challenge for both technician and user was identified in patients with CLP, though implementing this new approach of digital impression taking was otherwise found to be highly successful in everyday clinical routine.

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

“…Other authors have used commercially available CAD software solutions in their digital workflow [ 11 , 12 , 16 ]. Since there are no straightforward, affordable, and accessible software solutions, the difficulty of developing a practical and workable virtual workflow persists, which might hinder implementation and knowledge transfer to other cleft centers, especially with limited resources [ 12 ].…”

“…As conventional impressions are a risk for the infant’s airway [ 9 , 10 ], digital impression techniques, not having the risk of impression material aspiration or ingestion, provide a safer alternative. Digital impressions have become feasible in cleft care also for newborns and have been introduced in different centers [ 11 , 12 , 13 ]. Furthermore, digitization and three-dimensional (3D) printing increased the use of computer-aided design and manufacturing (CAD-CAM) in cleft care [ 14 , 15 , 16 ].…”

Digital impressions from newborns to preschoolers with cleft lip and palate: A two-centers experience

“…Further we analyzed whether scan duration depended on cleft type or the age of the patients. For comparability with previously reported studies, we divided the patients into three age groups as described in Weise et al 21 with an addition of a pre-school age group; (1) birth up to 28 days, (2) 29 days-365 days, (3) 1-3 years old, (4) 3-6 years old. We categorized the patients and scans according to cleft types to study its effect on scanning procedure: (1) soft palate cleft, (2) soft and hard palate cleft, (3) unilateral cleft lip and palate, (4) bilateral cleft lip and palate, (5) cleft lip and alveolus.…”

“…There have been several reports on single to few cases in infants with cleft lip and palate in the context of developing digital workflows for fabrication of orthopaedic appliances 10,19,20 . Recently Weise et al has reported an evaluation of intraoral scanning in infant to small children with craniofacial malformations 21 . However, assessment on integration of digital impression taking with intraoral scanners in clinical routines has still been scarce limiting the feasibility reported to handful of cases.…”

Kieferorthopädie als Fachdisziplin im Zentrum für Seltene Erkrankungen

“…Nach Abdrucknahme oder intraoralem Scan wird auf einem Gipsmodell des Oberkiefers oder per CAD/CAM eine Gaumenplatte aus Kunststoff angefertigt und im Mund des Säuglings angepasst (▶ abb. 2a) [34]. Die Gaumenplatte liegt passiv im Mund, so dass der Säugling angeregt wird, diese mit der Zunge am Gaumen zu halten, was einer Zungenrücklage und -hypotonie entgegenwirkt.…”