Feeding Obturator Research Articles

A Novel Self-Retentive Obturator to Facilitate Feeding in an Infant with Cleft Palate: A Case Report and Literature Review.

Cleft lip and palate are common congenital defects with multifactorial complex etiology characterized by complete or incomplete cleft of lip, alveolus, and hard and soft palate. In infants, the main problem lies in the difficulty of suckling with frequent nasal regurgitation leading to respiratory and middle ear infections. This article presents a case report of an 8-day-old female with complete cleft of hard and soft palate who was given a novel self-retentive type feeding obturator. This obturator eliminated the need for supplementary aids to help in retention and has a simple design, is cost-effective, and easy to use.

Perception and Attitude of Parents of Children With Orofacial Clefts Regarding the Use of Presurgical Orthopedics and Feeding Obturators.

This study aims to evaluate the parents' attitude and their perception regarding the management of orofacial cleft (OFC) children with presurgical nasoalveolar molding (PNAM), DynaCleft and/or feeding obturators. A cross-sectional, descriptiveand observational retrospective survey-based study was conducted among parents of OFC children treated with PNAM, DynaCleft and/or feeding obturators who attended a primary dental health care center in Al-Madinah, Saudi Arabia, from 2019 to 2023. A validated questionnaire was used after translating it from English to Arabic. The questionnaire consisted of 32 questions divided into two sections. The first section covers parents' sociodemographic data and OFC risk factors. The second section evaluates the parents' perception regarding the use of presurgical orthopedics (PSO) for OFC repair. The questionnaire was completed through telephone interviews carried out by two investigators with the parents of OFC children. Out of 142 parents of OFC children, only 40 parents and their children met the inclusion criteria of the study. Most parents (95%) reported their satisfaction with the treatment and stated that they would encourage other parents of OFC children to use PSO. This study concluded that parents of OFC children had a positive attitude towardPSO treatment. Based on the positive outcomes of PSO treatment reported in the current study and previous literature, PSO should be considered as a routine treatment in the early management of orofacial clefts.

Single visit feeding plate for infant: A case report.

A child born with cleft lip and palate may experience difficulties while feeding. It is the most common congenital craniofacial malformations. Feeding difficulties should be assessed and intervened as early as possible, as they are an important aspect of the multidisciplinary team approach in the management of cleft lip and palate. Feeding obturators improve feeding thereby contributing to weight gain and a thriving state of health, a prerequisite for surgical repair of the defects. A successful prosthesis should meet the physiological, psychological and aesthetic needs of the patient. This article describes the procedure for rehabilitation of cleft palate patient with feeding plate.

A feeding obturator appliance in infants with isolated cleft palate: A case series

ABSTRACT Feeding a child with cleft lip with or without cleft palate (CL/P) is a matter of concern for both the parents and the physician. Early knowledge about various available options and timely intervention can overcome undue anxiety in parents of children with CL/P. A feeding obturator separates the oral cavity from the nasal cavity and is one of the means to aid in adequate nutrition to the affected child. The present article describes two cases of successful use of a feeding obturator in infants with an isolated CL/P.

Effect of Feeding Obturator on Growth Parameter in a Patient with Pierre-Robin Sequence

Pierre-Robin Sequence is a developmental anomaly characterized by the triad of mandibular micrognathia, cleft palate, and glossoptosis. Neonates born with a cleft palate have difficulty in feeding that is further complicated by nasal regurgitation of food, excessive air intake, choking and recurrent aspiration pneumonitis. Due to difficulty in feeding, child’s growth can be affected. To combat these problems, different feeding interventions such as maternal advice and support, modified bottles, Orogastric/nasogastric tubes and feeding obturators, etc have been advocated. However, there is evidence of delay in the growth of children with a cleft as compared to those without clefting. The article describes the importance of measuring growth parameters to evaluate the growth of cleft palate patients.

A Novel two-step approach for impression making of an obturator in newborns with cleft lip and palate: A Case Report

A 2-day-old male newbornwas reported for not being able to breastfeed. Following examination he was diagnosed with a unilateral cleft lip and palate of left side with nasal communication.Because of the clefting, impression-making with finger-loaded elastomeric putty impression material was planned by a two-step impression technique.A big piece of sterile gauze was wrapped around the impression material in the first step. In step two, a customized special tray was fabricated on which the final impression was made,thenthe feeding obturator was fabricated using self-cure acrylic with sprinkle-on technique.The feeding obturator allowed the infant to suck easily.Without nasal regurgitation, the mother could feed the newbornsoon after placement. The parents were advised to keep the appliance in place until surgery was performed, with frequent follow-ups after 24 hours and monthly follow-ups after that.This case report explains the novel method of fabrication of feeding plates with an improved newborn's sucking capacity. Keywords: Cleft lip and palate, feeding plate, Newborn, Obturator, two-step

Flexible obturator in neonates with unilateral cleft lip and palate: Two case reports

Inborn cleft lip and palate is utmost encountered craniofacial anomaly. The ultimate issue a newborn with cleft lip and palate faces is the crisis in feeding, nasal puke and choking which additionally leads to nutrition scarcity and ultimately affects the overall grown of an infant. Feeding obturator bridges the space and facilitates feeding. This clinical case series demonstrates construction of a flexible obturator in 18 days old and 2 months old baby with cleft lip and palate. (Veau type III)

PREPARATION FOR PALATOPLASTY SURGERY WITH AN ACRYLIC FEEDING OBTURATOR: A CASE REPORT

ABSTRACTBackground: Clefts on the lips and palate are common cases to be found frequently in the field of dentistry. This gap connects the oral cavity and the nasal cavity so that it interferes with the nutritional intake in patients. The age and size of the oral cavity in patients become particular challenges for prosthetic rehabilitation. Another challenge lies at the impression procedure, because it is an essential part in the making of obturator. Objective: To provide information on the management of patient with cleft palate using feeding obturator from acrylic material. Case: A 13-months-old male patient arrived at Prof. Soedomo Gadjah Mada University Dental Hospital with his parents and was seeking for prosthetic therapy to cover the cleft on his palate because it had been muddling with food and beverage intake. Patient had undergone cheiloplasty surgery and further arranged for palatoplasty procedure. Intraoral examination exhibited a cleft extended from hard palate, soft palate, and uvula. Case management: Upper jaw impression was performed for individual tray fabrication, followed by impression procedure in an upright straight position until the patient bawled. The impression result was casted to construct an obturator using acrylic heat cure material. Fitting surface was covered with soft liner. Treatment result showed that the obturator was retentive, stable and able to assist the nutritional intake in patient. Conclusion: Acrylic feeding obturator can recover the condition in patient with cleft palate and improve nutritional intake as well as body weight to prepare patient for palatoplasty surgery.Keywords: Cleft Palate, Feeding Plate, Obturator

A feeding appliance for a newborn with Veau Type III cleft lip and palate: A case report

Congenital cleft lip and palate is the most commonly found craniofacial defect. The most common problem in an infant with cleft lip and palate is the difficulty in feeding due to communication between oral and nasal cavity. Difficulty in feeding leads to inadequate nutrition and affects the health of the infant. Feeding problems should be assessed and intervened as early as possible, as they are important aspect of the multidisciplinary team approach in the management of cleft lip and palate. Feeding obturator restores this gap and assists in feeding as well as helps in reduction of airway problems, regurgitations, and frequent infections. This clinical report describes a technique of fabrication of a feeding appliance in a 4 hours old neonate with veau type III cleft lip and palate. Keywords: Cleft lip; cleft palate; obturator; feeding appliance; feeding obturator; Veau Type III cleft lip and palate

MODIFIED FEEDING BOTTLE FOR INFANT WITH CLEFT LIP AND PALATE AT THE PERIPHERAL AREA: A CASE REPORT

Introduction:A newborn can suck at breast and latch well to get breast milk, but infants born with cleft lip and palate have difficulties to press the nipple by their tongues towards palatal direction. Case:A 10-day-old female infant came with complaint of not being able to breastfeed from a normal bottle and accordingly need to use spoon for milk feeding. She was planned to perform first step operation at 3 months with minimum 10 pounds of body weight. For nutrient intake, nasogastric tube had been placed on the patient. Case management :At the first visit, impression procedure was performed using red wax material that previously warmed thus it can be shaped according to the defect on infant’s palate. Subsequently, feeding obturator was fabricated using the resulting cast. Fabrication of feeding obturator used putty impression material combined with feeding bottle nipple. Thereafter, the modified feeding bottle was tried in the patient’s mouth. Conclusion:the use of putty material combined with feeding bottle nipple in infants with cleft palate may function as obturator. Furthermore, correction using the one of the modified feeding bottle can be carried out every 1-2 weeks until surgical repair of the cleft palate is performed.Keywords: cleft palate, feeding bottle, putty material, nutrition

Feeding difficulties in infants with unrepaired cleft lip and palate and HIV-exposure.

There is limited description of the feeding characteristics of infants with unrepaired cleft lip and palate, exposed to HIV, but not necessarily infected. To compare the feeding characteristics of infants with unrepaired cleft lip and palate and HIV-exposure, to infants with unrepaired cleft lip and palate only. A two-group comparative design with a validated measure, the Neonatal Feeding Assessment Scale was used. The effectiveness of oral feeding skills were included as objective measure. Twelve participants with unrepaired cleft lip and palate and HIV-exposure and 13 with unrepaired cleft lip and palate were matched according to cleft type and use of feeding obturator. There were no differences between the groups for mean age, birth weight and gestation. Participants were between two and 89 days old, bottle fed, and had no syndrome/co-occurring disorder. Nine (75%) participants in the research group and only two (15.38%) in the control grouppresented with the likelihood of oropharyngeal dysphagia. Apart from feeding difficulties as a result of structural impairment, the research group showed symptoms of neurological involvement. The research group presented with distinctive symptoms of oropharyngeal dysphagia. More studies using different measuring tools are required to strengthen the evidence.

Feeding Obturator in a Newly Born Child with Cleft Lip and Palate - A Case Report

Purpose: To understand the importance of feeding plate in infants with cleft palate and/or lip. Method: A feeding obturator was fabricated in an infant with cleft palate along with cleft lip. Result: A feeding obturator was fabricated and the infant was able to drink milk without regurgitation. Conclusion: The feeding obturator fabricated by this method was successfully used by the infant and it led to better nutrition status of the infant.

A novel method of obtaining impression from three-dimensionally printed skull and incorporating medical grade silicone elastomer in fabricating silicone palatal feeding obturators for cleft lip and palate cases

This report aims to depict a novel method in impression taking and feeding obturator fabrication for cleft lip and palate patients, utilizing three-dimensionally printed base of the skull from presurgical computerized tomography scan data. This technique uses soft and biocompatible medical grade room temperature vulcanizing silicone elastomer as the material of choice for fabrication procedure and reviews a representative patient case of a 10-month-old female child with bilateral cleft lip and palate deformity. Before final insertion, a strap was attached to the obturator as a safety precaution in case of accidental swallowing. The use of this unique technique satisfies all benefits of conventional feeding obturator with the added benefits of reducing most of its discomfort and difficulties of direct impression taking from the infant and fabricating process.

Feeding obturator as an airway adjunct during complete unilateral cleft palate repair.

Background and Aims:The palatal defect and abnormal dentition in cleft palate make mask ventilation and laryngoscopy difficult. This study aimed to assess the effect of feeding obturator on laryngeal view in unilateral complete cleft palate.Methods:Ninety non-syndromic infants scheduled for the first stage correction of complete unilateral cleft palate were randomised to Group A (no feeding obturator) or Group B (obturator used for induction and intubation). The primary objective was to assess effect of the feeding obturator on the Cormack–Lehane grade on laryngoscopy. Effects on face mask ventilation, easiness of laryngoscopy and intubation and the side effects were also measured.Results:Ninety patients completed the study. There was no statistically significant difference between the two groups regarding the CL grade (P < 0.1). However duration for intubation was significantly longer in Group A than Group B (31.4 ± 12.8 vs. 23.4 ± 40.7 sec, P < 0.001). The degree of difficulty of face mask ventilation was significantly greater in Group A than Group B (P < 0.008). Attempts for successful intubation and manoeuvres for successful intubation were significantly more in Group A than B (P < 0.05). Trauma occurred in ten patients in Group A relative to no patients in Group B.Conclusion:Use of a pre-sized obturator in infants with complete unilateral cleft palate does not improve the laryngoscopic view. However, it results in better face mask ventilation and easier and faster laryngoscopy and intubation.

Comparison Between Two Types of Feeding Obturators in Cleft Palate Babies

Comparison Between Two Types of Feeding Obturators in Cleft Palate Babies

Flexible feeding obturator for early intervention in infants with Pierre Robin sequence

Pierre Robin sequence presents with distinct features of retrognathia and glossoptosis with or without cleft palate, which results in potentially serious, life-threatening respiratory obstruction and feeding complications. A multidisciplinary approach is required to manage such complex features. This article describes a novel technique for managing Pierre Robin sequence using a flexible feeding obturator. This custom-made intraoral appliance overcomes numerous problems associated with the available feeding obturators and helps infants and parents cope with a variety of difficulties.

Fabrication of a Feeding Obturator for Infants.

Large clefts in the lip and palate are common congenital anomalies. If the cleft palate is large enough, conventional feeding techniques may not provide proper nutrition for the infant. Feeding obturators will aid in the ability of the infant to attain suction and help the infant to feed adequately. It is necessary for the infant to have sustained weight gain prior to surgery to correct the cleft lip and/or palate. Fabrication of an infant feeding obturator is a simple technique using materials found in every dental office. An impression is made using modeling plastic impression compound. This impression is relined using irreversible hydrocolloid, and the resulting cast is used to enable a vacuum-formed obturator to be fabricated. The vacuum-formed obturator is smoothed and adjusted in the infant's mouth to ensure closure of the palate but allows pace posteriorly to allow normal breathing. The resulting obturator is well retained in the infant's mouth, allowing feeding.

Single visit custom made flexible feeding obturator for an infant with tetralogy of fallot

Cleft lip and palate prevalence is more in patients with heart diseases than in patients with normal hearts. The co-existence of tetralogy of Fallot and cleft palate undermines the health of the infant by underfeeding and circulation of low arterial oxygen concentration. Early prosthodontic adjuvant therapy with feeding obturator is mandatory for rehabilitation till corrective surgery.

Prevalence, pattern and perceptions of cleft lip and cleft palate among children born in two hospitals in Kisoro District, Uganda.

BackgroundCleft lip with or without cleft palate is one of the most common congenital anomalies that affect the oro-facial region. The aim of the study was to determine the period prevalence, pattern and perceptions of cleft lip and cleft palate in children born between 2005 and 2010 in two hospitals in Kisoro District, Uganda.MethodsThe study involved a retrospective review of medical records of mothers who delivered live babies between January 2005 and December 2010 in Kisoro Hospital and St. Francis Hospital, Mutolere in Kisoro District. Key informant interviews of mothers (n = 20) of the children with cleft lip and/or clip palate and selected medical staff (n = 24) of the two hospitals were carried out. The data were analysed using descriptive statistics.ResultsOver the 6 year period, 25,985 mothers delivered live babies in Kisoro Hospital (n = 13,199) and St. Francis Hospital, Mutolere (n = 12,786) with 20 babies having oro-facial clefts. The overall period prevalence of the clefts was 0.77/1,000 live births. Sixty percent (n = 12) of children had combined cleft lip and palate and the same proportion had clefts on the left side of the face. More boys were affected than girls: 13 versus 7. About 45% of mothers were hurt on realizing that they had delivered a child with an oro-facial cleft. Forty percent of mothers indicated that a child with oro-facial cleft was regarded as an outcast. About 91.7% (n = 22) of the medical staff reported that these children were not accepted in their communities. Surgical intervention and psychosocial support were the management modalities advocated for by most respondents.Conclusion/recommendationsThe period prevalence of combined cleft lip and palate in two hospitals in Kisoro District was comparable to some findings elsewhere. Cleft lip and cleft palate are a medical and psychosocial problem in Kisoro District that calls for sensitization and counseling of the families and communities of the affected children. The policy makers need to strategically plan for provision of rehabilitation with feeding obturators to facilitate easy feeding to gain weight before surgical intervention of the affected children.

Quick and effective custom tray for a feeding obturator

Clefts of the lip and palate are the most common congenital craniofacial malformations in children. 1 Osuji OO Preparation of feeding obturators for infants with cleft lip and palate. J Clin Pediatr Dent. 1995; 19: 211-214 PubMed Google Scholar Sucking is impaired in infants born with clefts due to lack of negative pressure. 2 Jones JE Henderson L Avery DR Use of a feeding obturator for infants with severe cleft lip and palate. Spec Care Dentist. 1982; 2: 116-120 Crossref PubMed Scopus (24) Google Scholar Excess air intake during feeding, requiring additional burping, chocking, and nasal regurgitation of food are other complications associated with clefts. 3 Savion I Huband ML A feeding obturator for a preterm baby with Pierre Robin sequence. J Prosthet Dent. 2005; 93: 197-200 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar A feeding obturator improves feeding and thereby contributing to weight gain and a thriving state of health, a prerequisite for surgical repair of the defects. 1 Osuji OO Preparation of feeding obturators for infants with cleft lip and palate. J Clin Pediatr Dent. 1995; 19: 211-214 PubMed Google Scholar The severity of the clefts varies so much that stock trays are not always adequate for making the impression, and a custom tray is required. This article describes a simple and effective technique for fabricating a custom tray for the infant patient.