Research And Application Of Digital Presurgical Orthodontic Treatment For The Unilateral Cleft Lip And Palate Infants

Cleft lip and palate has a high incidence of maxillofacial deformity. According tostatistics there are20000infants with unilateral, bilateral cleft lip and cleft palate born inChina every year. Usually the team approach is recommended to deal with cleft lip andpalate. Presurgical nasoalveolar molding(PNAM) is the first and very important part ofseries treatment of chilopalatognathus. The purpose of PNAM is to achieve a narrowerdistance between a patient’s maxillary cleft segments, restore the position of theprotruding premaxilla and correct the external nasal collapse deformity. However, basedon the plaster model and the dentists’subjective experience, the shape and precision of thePNAM appliance is difficult to realize accurately control.Therefore, a new method ofartificial controlling, personalized designing, and automatic processing of the treatment is under neededed.In view of the above problems, this study used the Micro CT to establish the unilateralcomplete cleft lip and palate infants’ palate digital models, and established digital facemodels by3d MD face scanning equipment. Using geomagic software to design PNAMappliances and the nasal stent components for patients. The new digital method wasapplyed to clinical, and achieved remarkable effect. The followings are the results:1. The study established digital models of neonatals with cleft palate and lip by usingMicro CT method for the first time. What’more,the first time we used3d MD facestereophotogrammetry to collect the data of cleft lip and palate infants, and establisheddigital face models. This method not only can establish a clear boundary, a complete rangeof cleft palate, facial digitized model, but also in the software, complete facial landmarkpoints can be measured.2. By taking advantage of the computer aided technology,we can design the digital PNAMappliance to stimulate the process of narrowing the distance between a patient’s maxillarysegments. The digital PNAM appliance was written to a computer-readable medium in aSTL format that was supported by a software used in a rapid prototyping technology.Using Vacuum thermoforming unit and thermoforming double-layer platereplicated theformer resinous PNAM appliance into a new material so that can be worn in the mouth fora long time.3. For the first time, we used the computer aided design technology to design thepersonalized nasal stent components based on the contralateral external nasalmorphological.4. These methods are applied to the clinical to make the PNAM appliances for5unilateralcomplete cleft lip and palate infants, and the distance between the patient’s maxillarysegments were significantly reduced. After treatment, it can improve the patients’nasaldeformities with2unilateral complete lip and palate cleft infants with severe nasalcollapse.