title: Pitfalls and solutions in virtual design of nasoalveolar molding plates by using CAD/CAM technology--A preliminary clinical study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: lucas.ritschl@tum.de.
authors.forename: Lucas M
authors.initials: LM
authors.lastname: Ritschl
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: andrea.rau@tum.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rau
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: florian.guell@tum.de.
authors.forename: Florian D
authors.initials: FD
authors.lastname: Güll
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: benjamin.dibora@gmail.com.
authors.forename: Benjamin
authors.initials: B
authors.lastname: diBora
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: klaus-dietrich.wolff@tum.de.
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Mechanical Engineering, Technische Universität München, München, Germany. Electronic address: markus.schoenberger@tum.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Schönberger
authors.affiliation: Department of Mechanical Engineering, Technische Universität München, München, Germany. Electronic address: franz.bauer@tum.de.
authors.forename: Franz X
authors.initials: FX
authors.lastname: Bauer
authors.affiliation: Department of Mechanical Engineering, Technische Universität München, München, Germany. Electronic address: wintermantel@medtech.mw.tum.de.
authors.forename: Erich
authors.initials: E
authors.lastname: Wintermantel
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany. Electronic address: denys.loeffelbein@tum.de.
authors.forename: Denys J
authors.initials: DJ
authors.lastname: Loeffelbein
mesh_terms: D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D017076:Computer-Aided Design; D006801:Humans; D007223:Infant; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D013165:Splints; D016896:Treatment Outcome
keywords: CAD/CAM; Cleft lip and palate; Nasoalveolar molding; Rapid prototyping; Sequential production