{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:02:48Z","timestamp":1787166168348,"version":"build-2736575974"},"reference-count":87,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publishing Fund of University of T\u00fcbingen"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Robin sequence (RS) is a rare congenital anomaly characterized by micrognathia, glossoptosis, and upper airway obstruction (UAO), often accompanied by a cleft palate. The T\u00fcbingen Palatal Plate (TPP), also referred to as the pre-epiglottic baton plate (PEBP), offers a non-surgical, functional orthodontic solution that improves airway patency and feeding by advancing the tongue base. This paper outlines the semi-digital clinical and technical workflow used for TPP treatment at T\u00fcbingen University Hospital. The protocol combines intraoral scanning (IOS), computer-aided design and manufacturing (CAD\/CAM), and manual refinement for patient-specific appliance production. Practical steps, modifications for special cases and follow-up procedures are detailed, aiming to support clinical implementation at other centres. Based on the published literature and over three decades of experience, the protocol emphasizes safety, quality control, and interdisciplinary collaboration, with practical guidance provided to support implementation in other centres. The potential of digital workflows for data sharing, training, and multicenter collaboration is highlighted, while challenges such as the need for specialized expertise and technical resources are acknowledged. This guideline provides the first comprehensive and reproducible description of the T\u00fcbingen approach and aims to facilitate wider adoption of TPP therapy for infants with RS.<\/jats:p>","DOI":"10.3390\/bioengineering12101063","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:16:29Z","timestamp":1759241789000},"page":"1063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Complete Protocol and Guidelines for the Implementation and Manufacturing of the T\u00fcbingen Palatal Plate\u2014An Interdisciplinary Technical Note on the T\u00fcbingen Approach for Infants with Robin Sequence"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9618-5016","authenticated-orcid":false,"given":"Maite","family":"Aretxabaleta","sequence":"first","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3350-0290","authenticated-orcid":false,"given":"Marit","family":"Bockstedte","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Heise","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Theis","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Raible","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-6249","authenticated-orcid":false,"given":"Cornelia","family":"Wiechers","sequence":"additional","affiliation":[{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Department of Neonatology, T\u00fcbingen University Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Koos","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0066","authenticated-orcid":false,"given":"Christian F.","family":"Poets","sequence":"additional","affiliation":[{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Department of Neonatology, T\u00fcbingen University Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-0650","authenticated-orcid":false,"given":"Christina","family":"Weismann","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"},{"name":"Centre for Cleft Lip, Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, Osianderstr. 2-8, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1750-1172-9-9","article-title":"Birth prevalence and initial treatment of Robin sequence in Germany: A prospective epidemiologic study","volume":"9","author":"Vatlach","year":"2014","journal-title":"Orphanet J. 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