ABSTRACT
OBJECTIVE: This study aimed to propose digitally designed impression trays, for newborns with cleft lip and palate (CLP) defects, using the computer-assisted design and manufacturing (CAD/CAM) technique, based on measurements of width, length, and height made on processed and scanned plaster models. Thus, we will describe the different software and concepts that can be used for the design of these impression trays. DESIGN: A total of 59 plaster casts of newborn patients with CLP were collected and then scanned. After that, digital dental casts were three-dimensional (3D) evaluated, using precise anatomical landmarks. SETTING: The Maxillofacial Prosthodontics Team at the Dental consultation and treatment center in Rabat, Morocco. PATIENTS AND PARTICIPANTS: The study involved plaster casts of newborns with CLP, who had undergone presurgical neonatal treatment in the Maxillofacial Prosthodontics service in Rabat, Morocco. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): 3D evaluation of 59 scanned plaster casts of newborn patients with CLP. RESULTS: This work allowed us to obtain digital impression trays for each anatomical variation of orofacial clefts. These trays will limit the problems linked to conventional techniques for making neonatal orthopedic plates. We also emphasized the importance of a multidisciplinary approach involving several professionals in Morocco from various fields and specialties. CONCLUSION: This original technique is advantageous for the practitioner as well as for the patients and their parents. It allows for precise recording, better adaptation, time-saving, and parental comfort.
Subject(s)
Cleft Lip , Cleft Palate , Humans , Infant, Newborn , Cleft Lip/surgery , Cleft Palate/surgery , Maxilla , Computer-Aided DesignABSTRACT
Interrupting mandibular surgical resections may lead to mandibular deviation toward the resected side. This further complicates future surgical and prosthodontics reconstructions. The rehabilitation of this mandibular deviation by the specialist in maxillofacial prosthodontics is often done by guide devices. This helps to prevent or reduce postsurgical mandibular deviation. The current literature lacks data on a standard classification of these devices despite the various clinical situations that require different rehabilitation techniques. After a deep appraisal of the current literature on this topic and many years of experience, the authors propose an overview of the indications, the types, and an original classification of these prosthetic devices. We believe this new classification will facilitate communication among practitioners, the development of treatment plans, and the comparison of outcomes among different expert centers.
ABSTRACT
The face is an important part of the human body from an anatomical, functional, aesthetic and psychosocial point of view. It can be the site of several mutilations resulting from trauma, treatment of neoplasms and congenital malformations. The plastic facial prosthesis is therefore indicated to restore these facial deformities and to compensate for the various consequences. Recently, digital technologies have shown an increasing impact on the future of maxillofacial rehabilitation. Computer-aided design and manufacturing technique enabled practitioners to acquire numerical data, perform three-dimensional reconstructions, and then materialize and manufacture the facial epithesis through various manufacturing processes, by addition or subtraction. The aim of this article is to describe, through a clinical case, the steps of realization of a nasal epithesis by CAD/CAM, in a patient who underwent a surgical exeresis of the nasal pyramid following a squamous cell carcinoma. Thus, the clinical and technical aspects are highlighted, as follows, the taking of the impression, the materials used, the set-up and the make-up, as well as the software and the useful concepts for the computer-assisted realization of a facial plastic prosthesis of the nasal epithesis type. Our therapy will also focus on the interest of the multidisciplinary approach in Maxillofacial Prosthodontics.
