A feeding obturator for a preterm baby with Pierre Robin sequence

3D printed obturators - An innovative journey

The children suffering from cleft palate undergo physical and psychological trauma of a basic life function of feeding until the surgeon deems it suitable for corrective surgery. It is highly discouraging for the parents to face the ordeal being suffered by the child. Over the years, several modalities have been developed in the form of techniques and products to improve the feeding experience of the child. However, all of these products come with a certain set of problems including the difficulty of fabrication, cost, availability, etc. This article covers the journey of the D-cleft from the clinical trials of various designs and prototypes and improvement of the disadvantages of these finally leading to a device, which is easy to use, flexible, biocompatible, affordable, and customisable.

Single-visit Feeding Obturator Fabrication in Infants with Cleft Lip and Palate: A Case Series and Narrative Review of Literature

Cleft lip and palate (CLP) is one of the most common craniofacial anomaly affecting newborns. In the early years of life to survive baby requires nutrition from the mother. Lip seal of infant is affected because of cleft palate and thereby feeding is greatly compromised. As there is communication between nasal cavity and oral cavity there are more chances of aspiration of milk into the lungs. The main role of pedodontist is to fabricate a palatal obturator which facilitates feeding. In this article we have discussed fabrication of feeding obturator in single visit in infants with cleft palate.

Adaptation of vacuum-assisted mouthpiece head immobilization system for precision infant brain radiation therapy

PURPOSE

Our purpose was to describe an adaptation of a commercially available mouthpiece for vacuum-assisted mouthpiece immobilization for radiation therapy in infants.

METHODS AND MATERIALS

An infant diagnosed with a brain tumor required radiation therapy. After reviewing dental literature about obturators, we designed a modification for the smallest commercially available mouthpiece tray.

RESULTS

The patient was simulated with the adapted mouthpiece tray. We achieved excellent immobilization and had small daily image guided treatment position shifts. Our patient tolerated treatment well without injury to oral cavity or mucosa.

CONCLUSIONS

Head immobilization with a vacuum-assisted modified mouthpiece has not been described in infants. Our modification is a novel and safe and permits effective and accurate immobilization for infants for radiation therapy. New manufacturing technologies may allow creation of individualized mouthpieces.

A modified feeding plate for a newborn with cleft palate

Objectives : Cleft palate is a common congenital maxillofacial defect. We wish to present the fabrication of a modified feeding plate that will adapt to the changing palatal and velopharyngeal morphology during function. Case Report : A neonate with unilateral cleft lip and palate was referred to our clinic for the fabrication of a feeding plate. Intraoral examination revealed a cleft involving the uvula and the soft palate, with an alveolar defect on the left side. An impression was taken and a dental cast was obtained. A 1-mm Bioplast clear soft plate was pressed on the model. After trimming the edges of the plate, several retentive holes were made for its attachment to the hard plate. With the Bioplast soft plate replaced on the cast, plaster was used to cover parts of the soft plate that were not to come in contact with the hard plate. Biocryl resin was put on the retentive holes and 2-mm Biocryl C Rosa-transparent plate was pressed. The edges of the plate were cut, trimmed, and polished. Conclusion : This modified feeding plate effectively obstructed the soft palate defect. The adaptation of the flexible bulb of the appliance with the soft palate was excellent. Evaluation with nasoendoscopy revealed the synchronized movement of the bulb of the appliance with the soft palate during swallowing. Soft extension of the feeding plate eliminated the risk of irritation, and the baby accepted the appliance easily.

A preoperative appliance for a newborn with cleft palate

Cleft palate is a commonly observed congenital maxillofacial defect. One of the most important problems with clefts is the interference with feeding. An affected infant cannot produce negative pressure in the oral cavity and therefore cannot move the bolus backward to the pharynx. To obtain better nutritional intake prior to surgical correction, a palatal lift obturator is recommended. In this clinical report, a modified technique of obturator fabrication is presented. The new method uses a piece of tulle, a flexible and durable material that is frequently used in theater attire. With the help of this material, the bulb part is connected to the plate as a labile piece, and this connection acts like a natural velopharyngeal extension. Additionally, because of the softer property of the silicone elastomer, the posterior pharyngeal wall is less irritated.