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新生儿至学龄前腭裂患者的数字化印模:两中心经验。

Digital impressions from newborns to preschoolers with cleft lip and palate: A two-centers experience.

机构信息

Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Department of Clinical Research, University of Basel, Spitalstrasse 12, 4031 Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland.

Maxillofacial Department, Clinic of Pediatric Surgery, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw, Poland.

出版信息

J Plast Reconstr Aesthet Surg. 2022 Nov;75(11):4233-4242. doi: 10.1016/j.bjps.2022.08.015. Epub 2022 Aug 22.

Abstract

BACKGROUND

Documenting cleft lip and palate morphology prior to surgery is standard care. Presurgical orthopedic treatment also requires a 3D cleft model. Endangering the airway, conventional impressions require additional safety measures and resources. We investigate the implementation and risks of digital impressions for the youngest patients with orofacial clefts.

METHODS

We report a retrospective cohort study of patients with cleft lip and palate, aged up to 6 years, treated at two cleft centers in Europe (Basel (A), Warsaw (B)). We scanned with the Medit i500 (Medit Corp, Seoul, South Korea). Center A for presurgical orthopedics and prior surgery from June 2020 to March 2022. Center B prior surgery from December 2020 to May 2021. Scanning data were analyzed for adverse events and adverse device effects, scanning duration, and number of images according to cleft type and age.

RESULTS

We analyzed 342 digital impressions in 190 patients (center A: 71, B: 119). The median age was 8.7 months with a range from the first day of birth (presurgical orthopedics) to six years of life (early alveolar bone grafting). No adverse events or adverse device effects were observed. The median scan duration was 85.5 s for cleft palate and 50 s for cleft lip and nose (IQR 56 s and 39 s, respectively).

CONCLUSION

Digital impressions with intraoral scanners are safe in patients with cleft lip and palate from newborn to preschool age. Given the funding to purchase an intraoral scanner, interfaces to electronic patient records, and point-of-care 3D printing, cleft centers can successfully implement this technology.

摘要

背景

手术前记录唇腭裂形态是标准护理。术前矫形治疗也需要 3D 腭裂模型。传统的印模会危及气道,因此需要额外的安全措施和资源。我们研究了数字印模在患有唇腭裂的最小患者中的实施情况和风险。

方法

我们报告了一项回顾性队列研究,研究对象为年龄在 6 岁以下的唇腭裂患者,在欧洲的两个腭裂中心(巴塞尔(A),华沙(B))接受治疗。我们使用 Medit i500(Medit Corp,韩国首尔)进行扫描。中心 A 用于术前矫形和之前的手术,时间为 2020 年 6 月至 2022 年 3 月。中心 B 用于之前的手术,时间为 2020 年 12 月至 2021 年 5 月。根据腭裂类型和年龄,分析扫描数据中的不良事件和不良设备影响、扫描持续时间和图像数量。

结果

我们分析了 190 名患者的 342 个数字印模(中心 A:71,B:119)。中位年龄为 8.7 个月,范围从出生第一天(术前矫形)到 6 岁(早期牙槽骨移植)。未观察到不良事件或不良设备影响。腭裂的中位扫描时间为 85.5 秒,唇腭裂和鼻的中位扫描时间为 50 秒(IQR 分别为 56 秒和 39 秒)。

结论

对于新生儿至学龄前的唇腭裂患者,使用口腔内扫描仪进行数字印模是安全的。鉴于购买口腔内扫描仪、与电子病历接口以及即时 3D 打印的资金,腭裂中心可以成功实施这项技术。

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