Three-dimensional analysis of morphological changes in the maxilla of patients with cleft lip and palate.
OBJECTIVE
Three-dimensional (3-D) morphological changes in the maxilla of patients with cleft lip and palate (CLP) have been recorded, mainly using two-dimensional cast analyses. Although these seem to be insufficient, no standardized 3-D method has been developed until now. In this study, accuracy, precision, and validity of a newly developed 3-D digital computer-aided procedure to visualize and metrically analyze the growth of the edentulous maxilla of infants with CLP have been evaluated.


METHODS
The method was applied to 10 infants with complete unilateral CLP.


METHODS
Consecutive casts of the maxilla (1 week and 3, 6, and 12 months) of each patient were optically measured with a 3-D laser scanner. Following digitizing, the casts were computer reconstructed, aligned, and superimposed using specialized computer software. The distances between the surfaces were measured. Additionally, the surfaces were segmented perpendicular to the alveolar crest, the reference points being C1, C1', C2, C2', and I. The volumes of the resulting segments were determined and compared with one another.


RESULTS
The newly developed analysis enables a visualization of the extent and direction of morphological changes in the maxilla of infants with CLP. With this method it is possible to quantify these changes of the volume of defined alveolar segments.


CONCLUSIONS
The 3-D analysis developed is an ideal tool for the examination of 3-D morphological changes in the edentulous maxilla of patients with CLP. The results will serve as the starting point for a longitudinal study on the efficacy of different methods, not only of presurgical infant orthopedics but also of surgical procedures.
Braumann
Bert
B
Department of Orthodontics, Center for Dentistry, University of Bonn, Bonn, Germany. braumann@uni-bonn.de
Keilig
Ludger
L
Bourauel
Christoph
C
Jäger
Andreas
A
D000539:Alveolar Process / Q000254:growth & development / Q000473:pathology; D002971:Cleft Lip / Q000473:pathology* / Q000628:therapy; D002972:Cleft Palate / Q000473:pathology* / Q000628:therapy; D003724:Dental Arch / Q000254:growth & development / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods* / Q000706:statistics & numerical data; D007223:Infant; D007231:Infant, Newborn; D007834:Lasers; D008437:Maxilla / Q000254:growth & development / Q000473:pathology*; D003765:Models, Dental; D055095:Optics and Photonics; D010158:Palatal Obturators; D010865:Pilot Projects; D015203:Reproducibility of Results; D012984:Software