A simple solution to help with feeding difficulties in neonates with cleft palate: A case report.

Feeding a neonate baby with a complete cleft lip and palate is a problematic pursuit because of the communication between the oral and the nasal cavity and associated problems. This present case is of a 6-day-old underweight neonate with feeding difficulties due to the cleft palate. In this case report, simple, uncomplicated steps for the fabrication of a feeding obturator are explained to aid in the proper nourishment of neonates for definite corrective procedures in the future with overall growth.

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. HOW TO CITE THIS ARTICLE: Tirupathi SP, Ragulakollu R, Reddy V. Single-visit Feeding Obturator Fabrication in Infants with Cleft Lip and Palate: A Case Series and Narrative Review of Literature. Int J Clin Pediatr Dent 2020;13(2):186-191.

Rehabilitation of hemi-maxillectomy with a definite one piece hollow bulb obturator.

Maxillary intraoral defects due to surgical resection create an open link between the oral and nasal cavities causing difficulty in deglutition, speech, and an unaesthetic appearance. Prosthetic innervention is required to restore the needs of speech, mastication as well as closing the oroantral communication. This article shows a case report of systematic approach for fabrication of immediate plate just after surgery, followed by interim feeding plate 2 weeks after surgery, and finally definitive one piece hollow bulb obturator 6 months after surgery.

From birth till palatoplasty: Prosthetic procedural limitations and safeguarding infants with palatal cleft.

The most imminent issue to be addressed in a child born with cleft lip and/or palate is restoration of normal feeding. Early surgical treatment for cleft repair is crucial but may need to be postponed until certain age and weight gain is attained in an infant. When other feeding interventions fail in these children, prosthetic obturation of the defect with feeding instructions in the interim period is indicated to ward off the prevailing concerns. However, the entire prosthetic management presents a significant challenge with respect to the child's age, scope of iatrogenic injury to the delicate oral tissues, and potential for life-threatening situation during the procedures. This article draws attention toward preemptive measures which should be undertaken in the clinical setting during the fabrication of obturator to ascertain a desirable outcome without experiencing a grave complication that may arise due to ignorance and/or lack of facilities.

A prospective longitudinal study of postnatal dentoalveolar and palatal growth: The anatomical basis for CAD/CAM-assisted production of cleft-lip-palate feeding plates.

This study describes the dentoalveolar and palatal growth during the first months of life. Knowledge concerning this development is essential to avoid unwanted events such as mucosal ulcerations or restriction of growth when cleft-lip and palate (CLP) patients are treated. The results involve the generation of CAD/CAM CLP-feeding plates. Intraoral impressions from 32 healthy newborns were taken monthly for 5 months, supplemented by measurements of body weight, length, and occipital-frontal head circumference. The casts were digitalized, and two observers manually selected defined anatomical landmarks on virtual 3-D models. The distances between these landmarks were evaluted. Statistical analysis included an inter-rater agreement analysis and the determination of growth. In total, 213 casts were analyzed, with 65 models excluded because of inaccuracies in impression-taking or cast production. Overall longitudinal growth was 20.3%, whereas transversal growth reached a maximum of 21.1%. Vertical growth was 32.4% at the tuberal level. On the basis of these results, a semiautomated series of feeding plates allowing for monthly expansion could be generated. The acquired data serve as a useful reference for other pediatric and orthofacial investigations and treatments. One such application is the automated, fully virtual manufacture of CLP-feeding plates based on only one impression-taking. Our data reveal when caution is needed to prevent ulceration. The series of plates generated can minimize the time-consuming impression-taking and the production of further plaster models. The method of measurement is suitable for documentary purposes. Clin. Anat. 30:846-854, 2017. © 2017 Wiley Periodicals, Inc.

Clear double layer Bioplast feeding plate for neonates with cleft palate.

An infant with cleft palate was referred to cleft clinic of the Orthodontic Department. The mother was concerned to feed the child because of the escape of milk from the nose. Intraoral examination revealed a large palatal cleft extending from hard to soft palate involving uvula. The impression was taken and dental cast obtained. A 3 mm soft and afterward a 1 mm hard Bioplast plate was pressed using Biostar device (Scheu-Dental Gmbh, Iserlohn, Germany) on the model. Finally, a hole was prepared on the anterior part to put a thread through it. The infant tolerated the plate immediately and encounters no difficulties during feeding. The inlaying soft Bioplast plates eliminate the risk of tissue irritation, whereas the covering hard Bioplast plate supplies endurance. The fabrication of the clear Bioplast feeding plate is easy and less time-consuming compared with acrylic plates and may be recommended in crowded and overloaded cleft centers.

Single Visit Feeding Appliance for 1-day-old Neonate with Cleft Palate Using Safe Dental Putty-Gauze Hybrid Impression Technique for Maxillary Impression.

Cleft lip and palate is one of the most common craniofacial anomalies of humans. Intraoral impression making is the first clinical step in the fabrication of feeding appliance for infants with oro-nasal communication. It is difficult to control the flow of the impression material in the cleft area and undercuts in a child patient. This clinical report presents a simple and safe impression technique for maxillary impression making in neonates and infants with cleft palate. A gauze piece was used to confine the impression material during functional movements of sucking while impression making in an awake child to avoid the risk of aspiration or swallowing.

Naso alveolar molding in early management of cleft lip and palate.

Cleft lip and palate is a congenital anomaly occurring at birth. This article describes about the construction of feeding plate which is also used for naso alveolar molding (NAM). The main objective of this treatment is that this procedure minimizes the extent of surgery that should be done on newborns. Two infants with unilateral and bilateral cleft lip and palate are treated by making feeding plate and which is also used for NAM. Both the infants had favorable results, better in case of unilateral cleft lip patient; we hope that it will minimize the extent of surgery and the resultant scarring.

Pierre robin sequence and the pediatric dentist.

This article on the dental management of a neonate with Pierre Robin sequence describes the clinical and laboratory procedures for construction of a feeding plate due to the presence of a cleft palate. Emphasis has also been laid on a few literatures to describe medical complications associated with this condition. A 56-day-old neonate had been referred to the outpatient department with the complaint of difficulty in feeding, description, and management of which has been described in the case report.