MRI Modeling for 3D Printed Fabrication of Nasoalveolar Molding Appliance in Patients With Cleft Lip and Palate

Purpose: Present a novel technique for fabrication of nasoalveolar molding (NAM) appliances for neonates with cleft lip and palate (CLP) using magnetic resonance imaging (MRI). Study design: Proof-of-concept study. Setting/Participants: One patient with unilateral CLP was recruited for participation in this study at our institution. Interventions: This study employed 2 different methods for creating a NAM appliance, which is used in patients with CLP to improve anatomic positioning of the orofacial cleft in preparation for primary cheiloplasty. The patient underwent intraoral impression for traditional fabrication of a NAM appliance (PMMA-NAM) and also MRI of the face for digital fabrication of a NAM appliance (CAD-NAM). The 2 appliances were then compared using landmarks for measurements. Primary Outcome: Landmark measurements on NAM appliances; Clinical interchangeability of NAM appliances. Results: There was a statistically significant difference in the external arch width between the CAD-NAM and the PMMA-NAM. All other NAM measurements were statistically similar. Additionally, there was clinical success in the interchangeable fit of both appliances on both models. Conclusions: This technique could potentially eliminate the need for creation of an intraoral impression, as well as the adverse events associated with this, in the fabrication of NAM appliances. Larger studies are necessary to further define the efficacy of this novel approach and generalizability to other patients with CLP.