Digital orthodontics has emerged as a new paradigm of NasoAlveolar Molding (NAM). NAM is a well adopted adjunctive therapy before undergoing a lip surgery in patients with cleft lip and palate. Its mechanism is to apply differential force through a NAM plate. Conventional NAM uses a single plate, but with multiple adjustments. This causes high burden of care on patients and their families. Employing intra-oral scan and CAD/CAM, digital NAM simplifies NAM procedure and lessens clinical chair side. This also reduces a risk associated to mouth casting and allows plate reproducibility (in case of accidentally broken plates). However, early digital NAM requires design and fabrication of multiple plates throughout the process. A recent study proposes individualized Digital NAM (iDNAM) using biomechanics insight to minimize a number of plates. iDNAM has been shown to be clinically effective. Nonetheless iDNAM in its current state requires a personnel with craniofacial expertise and proficiency in 3D computer modeling. This article presents a pilot study toward an automatic iDNAM-plate design, using ellipse and non-parametric cross-section models. The approach takes advantages of specific data characteristics, allowing low-computation techniques to achieve three-dimension surface generation. The resulting design was assessed to provide a viable bridge model, one of the most challenging parts in plate design. This also supports our hypothesis of the elliptic-segment pattern of an alveolar ridge and shows prospect of our approach in a coveted fully automatic iDNAM-plate design.

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Bridge Model for Individualized Digital NasoAlveolar Molding Using Uniform Cross-Section Elliptic Segment

  • Hathaichanok Parakarn,
  • Buddhathida Wangsrimongkol,
  • Nawapak Eua-Anant,
  • Tatpong Katanyukul

摘要

Digital orthodontics has emerged as a new paradigm of NasoAlveolar Molding (NAM). NAM is a well adopted adjunctive therapy before undergoing a lip surgery in patients with cleft lip and palate. Its mechanism is to apply differential force through a NAM plate. Conventional NAM uses a single plate, but with multiple adjustments. This causes high burden of care on patients and their families. Employing intra-oral scan and CAD/CAM, digital NAM simplifies NAM procedure and lessens clinical chair side. This also reduces a risk associated to mouth casting and allows plate reproducibility (in case of accidentally broken plates). However, early digital NAM requires design and fabrication of multiple plates throughout the process. A recent study proposes individualized Digital NAM (iDNAM) using biomechanics insight to minimize a number of plates. iDNAM has been shown to be clinically effective. Nonetheless iDNAM in its current state requires a personnel with craniofacial expertise and proficiency in 3D computer modeling. This article presents a pilot study toward an automatic iDNAM-plate design, using ellipse and non-parametric cross-section models. The approach takes advantages of specific data characteristics, allowing low-computation techniques to achieve three-dimension surface generation. The resulting design was assessed to provide a viable bridge model, one of the most challenging parts in plate design. This also supports our hypothesis of the elliptic-segment pattern of an alveolar ridge and shows prospect of our approach in a coveted fully automatic iDNAM-plate design.