Nonsurgical Orthodontic Airway Plate Treatment for Newborns With Robin Sequence

Abstract

Despite promising outcomes for >50 years, nonsurgical orthodontic airway plates (OAP) are only infrequently offered for babies with Robin sequence in a few parts of the world. This article demonstrates possibility of providing functional improvement using an OAP to help these babies overcome their functional and structural difficulties on their own. Two consecutively treated cases are presented exemplifying that OAP treatment that had originated from Europe is reproducible and effective in an institution in the United States.

Split orthodontic airway plate: An innovation to the utilization method of conventional orthodontic airway plate for neonates with Robin sequence

“…The safety and effectiveness of nonsurgical OAP treatment in improving breathing and oral feeding difficulties of neonates with RS have been well documented in previous literature. [11][12][13][14] Its pharyngeal component dictates the posterior limit of the tongue base and serves as the anterior border of the pharynx, thereby guaranteeing the patency of upper airway for infants with RS. Although clinical data suggest that the OAP treatment may stimulate the mandibular catch-up growth in infants with RS, it is only speculated that the growth may occur in the context of the Melvin Moss' functional matrix theory postulating reactive nature of the bone growth to specific functional demands such as the guided anterior tongue movement.…”

“…10 A S-OAP is adjusted and installed inside a RS baby's mouth following the same protocol as conventional OAP delivery. 11 As the patient grows, an appearance of a linear continuous pressure mark on the labial slope of the maxillary alveolar ridge is an indication that the palatal plate is becoming too small for the growing maxillary arch. At this time, the S-OAP is split in half and slightly expanded by turning the embedded jackscrew (Figure 2B).…”

Disruptive Therapy Using a Nonsurgical Orthodontic Airway Plate for the Management of Neonatal Robin Sequence: 1-Year Follow-up

“…15,16 We previously published the 3-month follow-up on two neonates with severe RS treated with OAP and presented its immediate success as the first cases reported in the United States. 11 This case series from Lucile Packard Children's Hospital at Stanford University Medical Center illustrates the course of OAP treatment of these two patients with a focus on feeding, breathing, facial growth, and global development during their first year of life.…”

“…In contrast, nonsurgical orthodontic airway plate (OAP) treatment, such as the Tübingen Palatal Plate (TPP) or Pre-Epiglottal Baton Plate (PEBP), is a conservative causal treatment that resolves tongue-based breathing difficulty and promotes oral feeding and mandibular growth. [11][12][13] The use of OAP encourages patients to utilize their own but modified oral structures to transition to oral feeding by strategically positioning the tongue for effective bottle-feeding. Natural reduction of the cleft palate size ensues with long-term OAP use.…”

Automation of Measurements for Personalized Medical Appliances by Means of CAD Software—Application in Robin Sequence Orthodontic Appliances

“…Among potential medical applications, such solution may have huge potential for the retrospective measurement of individualized orthodontic appliances as employed in the Robin sequence [ 14 ], i.e., the Tübingen Palatal Plate (TPP). This treatment is a renowned alternative to surgical methods for treating these patients [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ] with favourable clinical results, which has been gaining international interest and has been adopted by different centres in recent years [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. These orthodontic appliances are used in newborns and small infants with the objective of relieving upper airway obstruction ( Figure 1 A).…”