Complete Protocol and Guidelines for the Implementation and Manufacturing of the Tübingen Palatal Plate-An...

Robin sequence (RS) is a rare congenital anomaly characterized by micrognathia, glossoptosis, and upper airway obstruction (UAO), often accompanied by a cleft palate. The Tübingen Palatal Plate (TPP), also referred to as the pre-epiglottic baton plate (PEBP), offers a non-surgical, functional orthodontic solution that improves airway patency and feeding by advancing the tongue base. This paper outlines the semi-digital clinical and technical workflow used for TPP treatment at Tübingen University Hospital. The protocol combines intraoral scanning (IOS), computer-aided design and manufacturing (CAD/CAM), and manual refinement for patient-specific appliance production. Practical steps, modifications for special cases and follow-up procedures are detailed, aiming to support clinical implementation at other centres. Based on the published literature and over three decades of experience, the protocol emphasizes safety, quality control, and interdisciplinary collaboration, with practical guidance provided to support implementation in other centres. The potential of digital workflows for data sharing, training, and multicenter collaboration is highlighted, while challenges such as the need for specialized expertise and technical resources are acknowledged. This guideline provides the first comprehensive and reproducible description of the Tübingen approach and aims to facilitate wider adoption of TPP therapy for infants with RS.