Computer-Aided Design and Computer-Aided Manufacturing Technology for Conducting Nasoalveolar Molding for Infants With Cleft Lip and Palate: A Scoping Review.

Abstract

ObjectiveTo identify, describe, and characterize computer-aided design and computer-aided manufacturing (CAD/CAM) methods for nasoalveolar molding (NAM) based on a structured search of scientific literature.DesignScoping review was conducted following the PRISMA-ScR guidelines. Searches were done in MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus. Screening and data extraction were performed.PatientsInfants with unrepaired, nonsyndromic, complete unilateral cleft lip and palate (UCLP), or bilateral cleft lip and palate (BCLP).InterventionCAD/CAM NAM.Main Outcome MeasuresOutcome measures were the digitization, virtual modeling, and manufacturing protocols.ResultsThirteen articles were included. CAD/CAM NAM involved digitizing the maxilla, designing step-by-step (stepwise) alveolar movements or expansion of plates, then manufacturing plates manually or through 3D printing. Four methods were characterized based on the virtual modeling and manufacturing techniques employed: stepwise alveolar molding and manually fabricated plates (SM_MP); stepwise alveolar molding and 3D-printed plates (SM_3P); stepwise plate expansion and 3D-printed plates (SPE_3P); and semi-automated plate expansion and 3D-printed plates (SAPE_3P). The SM_MP method was the most common, followed by the SM_3P, SPE_3P, and SAPE_3P methods. All methods were applied to treat infants with UCLP, whereas only the SM_MP and SM_3P methods were used for infants with BCLP.ConclusionsThis scoping review provides an overview of 4 CAD/CAM methods for NAM. The SM_MP and SM_3P methods simulate alveolar molding; however, the SM_3P method exhibits more advanced design and manufacturing of plates. The SPE_3P and SAPE_3P methods design consecutively enlarged plates, with the latter employing a semi-automated protocol.