New Digital Workflow for the Use of a Modified Stimulating Palatal Plate in Infants with Down Syndrome

Background: /Objectives: Down Syndrome (DS), the most common genetic disorder among newborns, is frequently associated with oral-motor dysmorphologies, such as oral hypotonia, tongue protrusion, short palate, and malocclusion, compromising the oral functions of sucking, chewing, swallowing, and speech production. Therapeutic interventions with stimulating palatal plates (SPP) have been proposed to prevent and improve oral-motor dysmorphologies in DS. This study proposes a new digital workflow for the manufacturing and use of a modified SPP. Methods: We report the step-by-step application of the new workflow to five clinical cases, all infants with DS, aged between 5 and 11 months, from the mouth scanning protocol and model printing to SPP manufacturing and delivering, and assessment of oral-morphological features and language abilities. Key novel features include a SPP with an acrylic extension with a pacifier terminal and, importantly, the use of an infant friendly intraoral scanner. Results: The new workflow had good acceptability by infants and parents, offering a safe, easy to implement and feasible solution for SPP design, as it avoided the high risks associated with impression materials. It also supported the use of the SPP to promote tongue stimulation, tongue retraction, and stimulate oral-muscle function in oral-motor disorders in children with DS, especially in infants. Conclusions: Within the limitations of the current study, it was shown that the proposed digital workflow constitutes a viable and infant-friendly approach to the production and use of SPP, and thus promises to contribute to improving oral morphology and promoting auditory-motor language abilities.