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

Domenico Dalessandri,Corrado Paganelli,Stefano Bonetti,Ingrid Tonni,Luca Visconti,Marco Migliorati,Gaetano Isola,Laura Laffranchi

doi:10.3390/dj7040111

Domenico Dalessandri, Corrado Paganelli + Show 6 more

Open Access

https://doi.org/10.3390/dj7040111

Copy DOI

Abstract

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.

Highlights

A complete unilateral cleft lip and palate patient growth is characterized by a severe nasal deformity, an outward, non-cleft side, maxillary alveolar process rotation and a medial movement of the cleft side, smaller alveolar segment [1,2]
In two tray and putty (T&P) patients the impression was repeated because repeated because some important anatomical details were missing, in one case due to patient some important anatomical details were missing, in one case due to patient regurgitation during the regurgitation during the first attempt
That is why we decided to concentrate on pre-surgical orthopedic treatment (PSOT), looking to ameliorate this technique by means of of a reduction in invasiveness and overall cost, maintaining, at the same time, the high clinical a reduction and overall cost, the same time, the high clinical standards standardsinofinvasiveness the classic technique based on maintaining, tray and puttyatimpressions and stone models

Summary

Introduction

A complete unilateral cleft lip and palate patient growth is characterized by a severe nasal deformity, an outward, non-cleft side, maxillary alveolar process rotation and a medial movement of the cleft side, smaller alveolar segment [1,2]. Visits are required to modify the molding plate to guide the alveolar cleft segments into the desired position [6,7,8]. Sometimes, this plate has to be substituted with additional impressions, in order to follow patient growth [9,10,11]

Objectives

Methods

Results

Discussion

Conclusion