Pitfalls and solutions in virtual design of nasoalveolar molding plates by using CAD/CAM technology—A preliminary clinical study

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• 作者：Lucas M. Ritschl^a ; ¹ ; ^{lucas.ritschl@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Andrea Rau^a ; ¹ ; ^{andrea.rau@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Florian D. Gü ; ll^a ; ^{florian.guell@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Benjamin diBora^a ; ^{benjamin.dibora@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Klaus-Dietrich Wolff^a ; ^{klaus-dietrich.wolff@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Markus Schö ; nberger^b ; ^{markus.schoenberger@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Franz X. Bauer^b ; ^{franz.bauer@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Erich Wintermantel^b ; ^{wintermantel@medtech.mw.tum.de" class="auth_mail" title="E-mail the corresponding author} ; Denys J. Loeffelbein^a ; ^{denys.loeffelbein@tum.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cleft lip and palate ; Nasoalveolar molding ; Rapid prototyping ; CAD/CAM ; Sequential production
• 刊名：Journal of Cranio-Maxillofacial Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：44
• 期：4
• 页码：453-459
• 全文大小：827 K

文摘

Computer-assisted design and computer-aided manufacturing (CAD/CAM) technology in nasoalveolar molding (NAM) should save time and manpower and reduce family input in cases of cleft lip and palate.

Material and methods

Intraoral casts from 12 infants with complete unilateral cleft lip and palate were taken immediately after birth (T₁) and after (T₂) NAM treatment, digitalized, and transformed into STL data. The infants were randomized into Group 1 (n = 6) receiving conventional NAM treatment or Group 2 receiving CAD/CAM NAM (n = 6). We analyzed the following variables by using Geomagic^© software: intersegmental alveolar distance (ISAD); intersegmental lip distance (ISLD); nostril height cleft/noncleft (NHc/nc); nasal width cleft/noncleft (NWn/nc); and columella deviation angle (CDA).

Results

In both groups, all variables except NHnc and NWnc were changed significantly between T₁ and T₂. The analysis of the mean differences of the variables in Group 1 and 2 showed no significant differences, with a comparable incidence of clinical alterations such as skin or mucosal irritations.

Conclusion

NAM plates can be produced virtually by using CAD/CAM technology. The CAD/CAM NAM results show no significant differences from the conventional technique. We present our clinically usable virtual CAD/CAM workflow for producing a basic NAM plate.