Fully digital workflow for presurgical orthodontic plate in cleft lip and palate patients

Objective: In most cases, according to our treatment concept, a presurgical orthodontic treatment (POT) is performed on patients with cleft lip and palate (CLP). The aim of this case report is to demonstrate a completely digital workflow for the production of a palate plate. Materials and methods: For the assessment of the maxillary arch, a digital impression of the jaw was made on two patients with an intraoral scanner (Cerec Omnicam Ortho). After reconstruction of a virtual model from the scan data, appropriate areas of the jaw could be blocked out and a plate constructed. This was printed with a DLP three-dimensional (3D) printer (SHERA EcoPrint D30) with class IIa biocompatible material. After minor surface finishing, the plates could be incorporated in the patients' mouths. Results: The scans could be performed in a short time without affecting the very young patients. All clinically relevant areas for the production and digital measurement of the models could be recorded. The plates showed an extremely good fit, and there were no differences in wear compared with a conventionally manufactured plate. Conclusion: For the first time, a risk-free digital impression of the edentulous jaw in CLP babies with a subsequently completely digitally constructed and 3D-printed palatal plate could be shown. Keywords: cleft lip and palate (CLP), computer-aided design/computer-aided manufacturing (CAD/CAM), three-dimensional (3D) printing, plate