Ahmed Mairaj K, Ahsanuddin Sofia, Retrouvey Jean-Marc, Koka Krishna Sai, Qureshi Haider, Bui Anthony H, Taub Peter J
Hansjorg Wyss Department of Plastic Surgery, NYU School of Medicine.
Department of Dental Medicine, NYU Langone Hospital.
J Craniofac Surg. 2019 Nov-Dec;30(8):2604-2608. doi: 10.1097/SCS.0000000000005921.
Nasoalveolar molding (NAM) is a presurgical orthopedic treatment modality that attempts to reorient misaligned bony and soft tissue structures in patients with clefting of the lip and palate. The NAM devices are implemented prior to surgical intervention in order to minimize the gap across the cleft and thereby reduce tension across the eventual repair. Currently, NAM devices are fabricated in a laboratory and then refined chairside by the provider. The present article describes the potential of three-dimensional (3D) printing and computer-aided design (CAD) software for the fabrication of NAM devices.
A workflow was developed to demonstrate the use of 3D printing and CAD software to design NAM devices. This workflow encompasses scanning an impression into CAD software, performing a series of manipulations, and then printing the digital model.
To test the workflow, a cleft palate plaster model was scanned into CAD software. Through a series of linear and angular freeform manipulations of the body, the model was modified to display a cleft with a reduced alveolar gap. Sequential molding devices were produced which would gradually apply pressure to targeted areas of hard and soft tissue until the cleft is minimized. The resulting devices are printed using a stereolithography printer.
The use of 3D printing and CAD software shows promise in improving the accuracy, speed, and cost-effectiveness of designing NAM devices. The accuracy and flexibility from digitally visualizing the manipulations made to an appliance before its creation can result in a more personalized device for the patient.
鼻牙槽塑形（NAM）是一种术前矫形治疗方式，旨在重新定位唇腭裂患者错位的骨骼和软组织结构。NAM装置在手术干预前使用，以尽量减小裂隙宽度，从而减轻最终修复处的张力。目前，NAM装置在实验室制作，然后由医护人员在椅旁进行调整。本文介绍了三维（3D）打印和计算机辅助设计（CAD）软件在制作NAM装置方面的潜力。
开发了一种工作流程，以展示使用3D打印和CAD软件设计NAM装置的过程。该工作流程包括将印模扫描到CAD软件中、进行一系列操作，然后打印数字模型。
为测试该工作流程，将腭裂石膏模型扫描到CAD软件中。通过对模型主体进行一系列线性和角度自由形式的操作，对模型进行修改，使其显示出牙槽裂隙减小的情况。制作了连续的塑形装置，这些装置将逐渐对硬组织和软组织的目标区域施加压力，直到裂隙最小化。最终的装置使用立体光刻打印机打印。
使用3D打印和CAD软件在提高NAM装置设计的准确性、速度和成本效益方面显示出前景。在制作器械之前，通过数字方式可视化对器械所做的操作，所获得的准确性和灵活性能够为患者带来更个性化的装置。
