title: Rating nasolabial appearance on three-dimensional images in cleft lip and palate: a comparison with standard photographs.
abstract: OBJECTIVE
  Judgement of nasolabial aesthetics in cleft lip and palate (CLP) is a vital component of assessment of treatment outcome. It is usually performed based on two-dimensional (2D) facial photographs. An increasing use of three-dimensional (3D) imaging warrants an assessment if 3D images can substitute 2D photographs during aesthetic evaluation. The aim of this study was to compare reliability of rating nasolabial appearance on 3D images and standard 2D photographs in prepubertal children.
  
  
  METHODS
  Forty subjects (age: 8.8-12) with unilateral CLP treated according to a standardized protocol, who had 2D and 3D facial images were selected. Eight lay raters assessed nasal form, nasal deviation, vermilion border, and nasolabial profile on cropped 2D and 3D images using a 100-mm visual analogue scale (VAS). Additionally, raters answer two questions: 1. Do 2D or 3D images provide more information on nasolabial aesthetics? and 2. Is aesthetic evaluation easier on 2D or 3D images?
  
  
  RESULTS
  Intrarater agreement demonstrated a better reliability of ratings performed on 3D images than 2D images (correlation coefficients for 3D images ranged from 0.733 to 0.857; for 2D images from 0.151 to 0.611). The mean scores showed, however, no difference between 2D and 3D formats (>0.05). 3D images were regarded more informative than 2D images (P = 0.001) but probably more difficult to evaluate (P = 0.06).
  
  
  CONCLUSIONS
  Basal view of the nose was not assessed.
  
  
  CONCLUSIONS
  3D images seem better than 2D images for rating nasolabial aesthetics but raters should familiarize themselves with them prior to rating.
authors.affiliation: Division of Maxillofacial Surgery, Department of Stomatology and Maxillofacial Surgery, Comenius University, Bratislava, Slovakia, Departments of.
authors.forename: Adam
authors.initials: A
authors.lastname: Stebel
authors.affiliation: Orthodontics and Craniofacial Biology.
authors.forename: Dries
authors.initials: D
authors.lastname: Desmedt
authors.affiliation: Community and Restorative Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Ewald
authors.initials: E
authors.lastname: Bronkhorst
authors.affiliation: Orthodontics and Craniofacial Biology.
authors.forename: Mette A
authors.initials: MA
authors.lastname: Kuijpers
authors.affiliation: Department of Orthodontics, Palacky University, Olomouc, Czech Republic, and *****Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland Piotr.Fudalej@zmk.unibe.ch.
authors.forename: Piotr S
authors.initials: PS
authors.lastname: Fudalej
mesh_terms: D000328:Adult; D002648:Child; D002971:Cleft Lip / Q000473:pathology* / Q000601:surgery; D002972:Cleft Palate / Q000473:pathology* / Q000601:surgery; D004954:Esthetics; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008046:Lip / Q000033:anatomy & histology*; D009666:Nose / Q000033:anatomy & histology*; D009667:Nose Deformities, Acquired / Q000473:pathology; D010780:Photogrammetry / Q000379:methods; D010781:Photography / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D015203:Reproducibility of Results; D016896:Treatment Outcome; D064232:Visual Analog Scale