Department of Orthodontics, University Hospital Tuebingen, Germany.
Center for Cleft Palate and Craniofacial Malformations, University Hospital Tuebingen, Germany.
Eur J Orthod. 2022 May 24;44(3):279-286. doi: 10.1093/ejo/cjab068.
The aim of this study was to evaluate intraoral scanning (IOS) in infants, neonates, and small children with craniofacial anomalies for its feasibility, scanning duration, and success rate. Impression taking in vulnerable patients can be potentially life-threatening, with the risk of airway obstruction and aspiration of impression material. The advantage of increasingly digitalized dentistry is demonstrated.
IOS was captured with the Trios 3® (3Shape, Copenhagen, Denmark) intraoral scanner. The underlying disorders were divided into cleft lip and palate (CLP), Trisomy 21 (T21), Robin Sequence (RS), Treacher Collins syndrome (TC), and isolated mandibular retrognathia (MR). Scan data were analysed by scanning duration, number of images, possible correlations of these factors with the different craniofacial disorders, patient age, and relationship between first and subsequent scans. Clinical experiences with the repeated digital impressions are described.
Patient data of 141 scans in 83 patients were analysed within an 11-month period. Patients had a median age of 137 days. Median scanning duration was 138 seconds, resulting in a median of 352 images. There was a statistically significant difference in scanning duration (P = 0.001) between infants and neonates. IOS took longest in patients with CLP (537 seconds) and shortest in T21 patients (21 seconds), although there was no statistically significant difference between aetiologies. There was no statistically significant difference between first and subsequent scans in scanning duration. In four cases the IOS had to be repeated, and one patient ultimately required conventional impression taking (all CLP patients; success rate 94%). No severe adverse events occurred.
IOS is a fast, safe, and feasible procedure for neonates, small children, and infants with craniofacial malformations. One special challenge for both technician and user was identified in patients with CLP, though implementing this new approach of digital impression taking was otherwise found to be highly successful in everyday clinical routine.
本研究旨在评估口腔内扫描（IOS）在颅面畸形的婴儿、新生儿和幼儿中的可行性、扫描时长和成功率。在脆弱的患者中进行印模制取可能具有潜在的生命威胁，存在气道阻塞和吸入印模材料的风险。本研究展示了日益数字化的牙科的优势。
使用 Trios 3®（3Shape，哥本哈根，丹麦）口腔内扫描仪进行 IOS 采集。基础疾病分为唇腭裂（CLP）、21 三体综合征（T21）、Robin 序列（RS）、Treacher Collins 综合征（TC）和下颌骨后缩（MR）。通过扫描时长、图像数量对扫描数据进行分析，并分析这些因素与不同颅面畸形、患者年龄以及首次和后续扫描之间的关系。同时还描述了重复数字化印模的临床经验。
在 11 个月的时间内，对 83 名患者的 141 次扫描患者数据进行了分析。患者的中位年龄为 137 天。中位扫描时长为 138 秒，产生的图像中位数为 352 张。婴儿和新生儿的扫描时长存在统计学显著差异（P = 0.001）。CLP 患者的 IOS 耗时最长（537 秒），T21 患者耗时最短（21 秒），但病因之间无统计学显著差异。扫描时长在首次和后续扫描之间无统计学显著差异。有 4 例 IOS 必须重复，1 例患者最终需要进行传统印模制取（均为 CLP 患者；成功率 94%）。未发生严重不良事件。
IOS 是一种快速、安全且可行的方法，适用于颅面畸形的新生儿、幼儿和婴儿。尽管在 CLP 患者中遇到了一个特殊的挑战，但新技术的应用在日常临床实践中非常成功。
