591 Efficacy of a 3D Printed Microstomia Orthosis on Mouth Opening and Function, a Case Series
Bibliographic record
Abstract
Abstract Introduction Microstomia, often observed following facial burn injuries, can hinder functional activities such as eating, speaking, dental care, and medical procedures such as intubation. Thus, microstomia orthoses (MO) are used to increase mouth opening and function. Various designs of custom fabricated MOs have been published, however, to the best of our knowledge, the first report of a 3D MO for mouth burns was presented at the 2023 ABA conference. This 3D MO was modified to generate additional sizes and address issues of comfort and material rigidity. The modified 3D MO (available on Thingverse) was then trialed with 3 patients at different stages of their rehabilitation and their outcomes documented. Methods The purpose of this case series was to evaluate the efficacy of a 3D MO on mouth opening and function when used to treat 3 adult burn survivors. The mouth impairment and disability assessment (MIDA), including measures of horizontal and vertical mouth opening, was completed before the use of the 3D MO and after 4 months of wear. All participants had previously reached a plateau on the MIDA and opening measures after the use of various commercially available MOs before starting the 3D MO. They were also asked to evaluate the comfort and whether they would modify any aspect of the MO. Results The total material cost of this MO ranged from 2-3 $CAD. The print time ranged between 5.5-8 hrs (depending on mouthpiece size) using a 3D printer valued at ~250$CAD. The 3 participants were male with a mean age of 40 years, mean TBSA of 9.5% and 2/3 participants received face grafts. Patients started using the 3D MO at different timepoints post-burn: 4m, 9m and 15m. The 4-month post 3D MO wear MIDAs are currently being completed. However, one patient completed the questionnaire, which improved by15 points. Another patient was able to avoid having reconstructive surgery. To date, all patients improved both their horizontal and vertical mouth opening measures (mean improvement - horizontal: 0.72 (0.52) cm range [0.16-1.2]; vertical: 0.92 (0.41) cm range [0.67-1.4]). The MOs were worn between 2 weeks-4 months for a minimum of 30 min/day to achieve these results, but data collection is ongoing. All patients reported that the MO was comfortable, and they prefer it to all the MOs they had worn previously. Conclusions Although data collection is ongoing, patients who had previously plateaued have improved function and oral opening after the application of this modified 3D MO. Applicability of Research to Practice This cost-effective solution increases accessibility of MOs for individuals who do not have access to commercially available MOs. The need for economically feasible alternatives is particularly important in developing countries where burn injuries are more prevalent.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".