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Presurgical Maxillary Orthopedic

Presurgical Maxillary Orthopedic. Elan Bomsztyk, Alissa Garman, Shannon Kane, Aaron Kroner & Sarah Schram. Advisor: Mitch Tyler Clients: Michael L. Bentz, M.D., FAAP, FACS, John F. Doyle, D.D.S., F.A.D.I. Problem Statement.

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Presurgical Maxillary Orthopedic

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  1. Presurgical Maxillary Orthopedic Elan Bomsztyk, Alissa Garman, Shannon Kane, Aaron Kroner & Sarah Schram Advisor: Mitch Tyler Clients:Michael L. Bentz, M.D., FAAP, FACS, John F. Doyle, D.D.S., F.A.D.I

  2. Problem Statement • Design an orthopedic device for pre-surgical manipulation of cleft palate with a universal mechanism that: -encompasses the benefits of current devices -allows movement in two or three dimensions -is easily adjustable

  3. Background: Cleft Palate • A deformity in which the palate is not completely formed and the nasal cavity opens into the mouth • Occurs in ~1 out of every 800 infants • Surgical closure at ~ 6-18 months of age • Unilateral or Bilateral

  4. Background: Presurgical Maxillary Orthopedics • Decrease or maintain width of cleft • Decrease tissue tension post surgery • Restore maxillary arch contour • Aid in feeding • Two Types: -Active -Passive

  5. Current Devices: • Passive Palate • Nordin Devices • Jackscrew Device • Latham

  6. Product Design Specifications • Translation and rotation in 2 or 3 dimensions • Provide false palate • Accommodate uni- & bi-lateral clefts • Continuous usage in mouth for 7-9 weeks • Easily adjustable • Weigh 3-4 grams or less • Cost $500-600

  7. Design Alternatives • Acrylic pieces molded to patient’s gums • Denture Adhesive • Optional medical tape • Expansion-Retraction Screw

  8. Design Alternatives Acrylic with Rubber Bands Device • Pros -Creates a false palate -Various planes of movement -Accommodates uni- & bilateral clefts • Cons -Does not expand -Limitations of rubber bands -Complicated rubber band attachment

  9. Design Alternatives Updated Latham • Pros -Independent movement of alveolar segments - 3D force - Creates false palate • Cons -Choking reflex

  10. Design Alternatives Beautiful Baby 2001 Before After

  11. Future • Evaluate design alternatives • Construct decision matrix • Build & test prototype

  12. Questions

  13. Current Devices: • Passive Palate • Pros: -Provides false palate -Prevents worsening of the cleft • Cons: -No adjustment of cleft • Jackscrew Device • Pros: -Specific manipulation of palatal segments -Tongue kept out of cleft • Cons: -Multiple clinical visits -no rotation of the alveolar segments

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