Digital workflow and 3D printing of palato-lingual plates for robin sequence: current concepts and future directions
摘要
Robin sequence (RS) is a congenital craniofacial condition characterized by micrognathia, glossoptosis, and upper airway obstruction, frequently leading to life-threatening respiratory compromise and feeding difficulties in the neonatal period. Palato-lingual plates (PLPs) represent an effective non-invasive therapeutic approach. However, conventional fabrication relies on manual impressions and handcrafted acrylic processing, which are laborious and potentially hazardous. While recent digital attempts have utilized intraoral scanning and 3D printing to improve manufacturing efficiency, they largely focus on replicating traditional analog designs. This review presents a synthesized digital workflow that extends beyond mere replication to offer a platform for conceptual innovation. The specific advancement of this workflow lies in the implementation of iterative digital enlargement, which accommodates patient growth while minimizing the need for repeated scanning, and the integration of protective facial buttons. By incorporating flexible components designed to respect the specific geometry and dynamics of the oral cavity and pharynx, this workflow reflects an evolution toward next-generation hybrid appliances that integrate the functional principles of both palato-lingual plates and airway stents. This integration, supported by additive manufacturing, suggests a promising direction for the development of more adaptive therapeutic appliances that eliminate the need for extraoral fixation wires. This shift may enhance patient comfort and support the possibility of breastfeeding, thereby addressing long-standing clinical limitations by prioritizing patient tolerance and functional outcomes. Ultimately, this digital approach represents not just a technological improvement in fabrication, but a standardized, reproducible management model that facilitates multicenter collaboration and iterative design prototyping for infants with Robin sequence.