{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:28:33Z","timestamp":1789475313472,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Botnar Research Centre for Child Health (BRCCH)"},{"name":"Propatient Research Foundation of the University Hospital Basel"},{"name":"Department of Surgery at the University Hospital of Basel"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Cleft lip and palate are one of the most common congenital craniofacial malformations. As an initial treatment, presurgical orthopedics is considered standard treatment at many cleft centers. Digital impressions are becoming feasible in cleft care. Computer-aided design (CAD) and three-dimensional (3D) printing are manufacturing standards in dentistry. The assimilation of these technologies has the potential to alter the traditional workflow for the fabrication of customized presurgical orthopedic plates. We present a digital workflow comprising three steps: 3D digital image acquisition with an intraoral scanner, open-source CAD modeling, and point-of-care 3D printing for the fabrication of personalized passive presurgical plates for newborns with cleft lip and palate. The digital workflow resulted in patient-related benefits, such as no risk of airway obstruction with quicker data acquisition (range 1\u20132.5 min). Throughput time was higher in the digital workflow 260\u2013350 min compared to 135 min in the conventional workflow. The manual and personal intervention time was reduced from 135 min to 60 min. We show a clinically useful digital workflow for presurgical plates in cleft treatment. Once care providers overcome procurement costs, digital impressions, and point-of-care 3D printing will simplify these workflows and have the potential to become standard for cleft care.<\/jats:p>","DOI":"10.3390\/children9081261","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T21:05:51Z","timestamp":1661115951000},"page":"1261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["A Point-of-Care Digital Workflow for 3D Printed Passive Presurgical Orthopedic Plates in Cleft Care"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6858-6146","authenticated-orcid":false,"given":"Parichehr","family":"Zarean","sequence":"first","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-3066","authenticated-orcid":false,"given":"Paridokht","family":"Zarean","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3035-9308","authenticated-orcid":false,"given":"Florian M.","family":"Thieringer","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1973-9281","authenticated-orcid":false,"given":"Andreas A.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Facial and Cranial Anomalies Research Group, Department of Clinical Research and Department of Biomedical Engineering, University of Basel, Spitalstrasse 12, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Kressmann","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Erismann","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Facial and Cranial Anomalies Research Group, Department of Clinical Research and Department of Biomedical Engineering, University of Basel, Spitalstrasse 12, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-0945","authenticated-orcid":false,"given":"Neha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-6603","authenticated-orcid":false,"given":"Benito K.","family":"Benitez","sequence":"additional","affiliation":[{"name":"Oral and Craniomaxillofacial Surgery, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland"},{"name":"Facial and Cranial Anomalies Research Group, Department of Clinical Research and Department of Biomedical Engineering, University of Basel, Spitalstrasse 12, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"ref_1","first-page":"126","article-title":"Orthodontic procedures in the treatment of congenital cleft palate","volume":"70","author":"McNeil","year":"1950","journal-title":"Dent. Rec."},{"key":"ref_2","first-page":"405","article-title":"Early maxillary orthopedics in CLP cases: Guidelines for surgery","volume":"15","author":"Hotz","year":"1978","journal-title":"Cleft Palate J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1597\/1545-1569_2001_038_0193_pnomip_2.0.co_2","article-title":"Presurgical nasoalveolar orthopedic molding in primary correction of the nose, lip, and alveolus of infants born with unilateral and bilateral clefts","volume":"38","author":"Grayson","year":"2001","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_4","first-page":"253","article-title":"An extraorally activated expansion appliance for cleft palate infants","volume":"13","author":"Latham","year":"1976","journal-title":"Cleft Palate J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1097\/01.prs.0000270847.12427.25","article-title":"Experience with presurgical nasal molding in infants with cleft lip and nose deformity","volume":"120","year":"2007","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jcms.2021.07.002","article-title":"Continuous circular closure in unilateral cleft lip and plate repair in one surgery","volume":"50","author":"Benitez","year":"2022","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_7","first-page":"1422","article-title":"Preoperative columella lengthening in bilateral cleft lip and palate","volume":"92","author":"Grayson","year":"1993","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1597\/1545-1569_1999_036_0486_pnmiiw_2.3.co_2","article-title":"Presurgical nasoalveolar molding in infants with cleft lip and palate","volume":"36","author":"Grayson","year":"1999","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E58","DOI":"10.1002\/ppul.23710","article-title":"Unnoticed aspiration of palate plate impression material in a neonate: Diagnosis, therapy, outcome","volume":"52","author":"Reichert","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1179\/bjo.22.4.299","article-title":"A report on the hazards encountered when taking neonatal cleft palate impressions (1983\u20131992)","volume":"22","author":"Chate","year":"1995","journal-title":"Br. J. Orthod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/ejo\/cjab068","article-title":"Intraoral scanning of neonates and infants with craniofacial disorders: Feasibility, scanning duration, and clinical experience","volume":"44","author":"Weise","year":"2022","journal-title":"Eur. J. Orthod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/SCS.0000000000006258","article-title":"Full Digital Workflow of Nasoalveolar Molding Treatment in Infants with Cleft Lip and Palate","volume":"31","author":"Gong","year":"2020","journal-title":"J. Craniofacial Surg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Benitez, B.K., Brudnicki, A., Surowiec, Z., Wieprzowski, \u0141., Rasadurai, A., Nalabothu, P., Lill, Y., and Mueller, A.A. (2022). Digital Impressions from Newborns to Preschoolers with Cleft Lip and Palate: A Two-Centers Experience. J. Plast. Reconstr. Aesthet. Surg., Accepted for Publication.","DOI":"10.1016\/j.bjps.2022.08.015"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/1055665621990152","article-title":"Evaluation of the Clinical Effectiveness of Nasoalveolar Molding (NAM) Using Grayson Method Versus Computer-Aided Design NAM (CAD\/NAM) in Infants with Bilateral Cleft Lip and Palate: A Randomized Clinical Trial","volume":"59","author":"Fayed","year":"2022","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1515\/cdbme-2016-0152","article-title":"Automated detection of alveolar arches for nasoalveolar molding in cleft lip and palate treatment","volume":"2","author":"Bauer","year":"2016","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Xepapadeas, A.B., Weise, C., Frank, K., Spintzyk, S., Poets, C.F., Wiechers, C., Arand, J., and Koos, B. (2020). Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans\u2014Part I: 3D printed and milled palatal stimulation plate for trisomy 21. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-1001-4"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sharma, N., Cao, S., Msallem, B., Kunz, C., Brantner, P., Honigmann, P., and Thieringer, F.M. (2020). Effects of Steam Sterilization on 3D Printed Biocompatible Resin Materials for Surgical Guides-An Accuracy Assessment Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051506"},{"key":"ref_18","unstructured":"(2022, May 03). Formlabs. Available online: https:\/\/formlabs.com\/de\/shop\/biomed-clear-resin\/."},{"key":"ref_19","unstructured":"(2022, May 03). Formlabs. Available online: https:\/\/support.formlabs.com\/s\/article\/Form-Cure-Time-and-Temperature-Settings?language=en_US#download."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.prosdent.2016.09.024","article-title":"Evaluation of the accuracy of 7 digital scanners: An in vitro analysis based on 3-dimensional comparisons","volume":"118","author":"Renne","year":"2017","journal-title":"J. Prosthet. Dent."},{"key":"ref_21","first-page":"10556656221109416","article-title":"Presurgical Cleft Management of Infants: A Survey of ACPA Approved and International Cleft Palate and Craniofacial Teams","volume":"20","author":"Jensen","year":"2022","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Nalabothu, P., Benitez, B.K., Dalstra, M., Verna, C., and Mueller, A.A. (2020). Three-Dimensional Morphological Changes of the True Cleft under Passive Presurgical Orthopaedics in Unilateral Cleft Lip and Palate: A Retrospective Cohort Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9040962"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1177\/10556656211031419","article-title":"Histologic Aspect of the Curved Vomerine Mucosa in Cleft Lip and Palate","volume":"59","author":"Benitez","year":"2022","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chiu, A., Chen, Y.W., Hayashi, J., and Sadr, A. (2020). Accuracy of CAD\/CAM Digital Impressions with Different Intraoral Scanner Parameters. Sensors, 20.","DOI":"10.3390\/s20041157"},{"key":"ref_25","unstructured":"Griffin, R., Botond, S., Anthony, M., Zachary, P., Walter, R., Mark, L., and J\u00e1nos, V. (2021). Evaluation of complete-arch implant scanning with 5 different intraoral scanners in terms of trueness and operator experience. J. Prosthet. Dent., in press."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Aretxabaleta, M., Unkovskiy, A., Koos, B., Spintzyk, S., and Xepapadeas, A.B. (2021). Accuracy evaluation of additively and subtractively fabricated palatal plate orthodontic appliances for newborns and infants-an in vitro study. Materials, 14.","DOI":"10.20944\/preprints202107.0317.v1"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1002\/ppul.25317","article-title":"Pierre Robin and breathing: What to do and when?","volume":"57","author":"Poets","year":"2022","journal-title":"Pediatr. Pulmonol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Xepapadeas, A.B., Weise, C., Frank, K., Spintzyk, S., Poets, C.F., Wiechers, C., Arand, J., and Koos, B. (2020). Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans\u2014Part II: 3D printed T\u00fcbingen palatal plate prototype for newborns with Robin sequence. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01159-7"},{"key":"ref_29","unstructured":"(2022, August 05). Botnar Research Center for Child Health Home Page. Available online: https:\/\/brc.ch\/research\/cleft-lip-and-palate\/."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1177\/1055665620929224","article-title":"What Is the Burden of Care of Nasoalveolar Molding?","volume":"57","author":"Alfonso","year":"2020","journal-title":"Cleft Palate Craniofacial J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1097\/SCS.0000000000006929","article-title":"Presurgical Orthopedic Intervention Prior to Cleft Lip and Palate Repair: Nasoalveolar Molding Versus Passive Molding Appliance Therapy","volume":"32","author":"Gibson","year":"2021","journal-title":"J. Craniofacial Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/SCS.0000000000007026","article-title":"Nasoalveolar Molding: Assessing the Burden of Care","volume":"32","author":"Wlodarczyk","year":"2021","journal-title":"J. Craniofacial Surg."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1261\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:13:01Z","timestamp":1760141581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["children9081261"],"URL":"https:\/\/doi.org\/10.3390\/children9081261","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,20]]}}}