GAND classification and volumetric assessment of unilateral cleft lip and palate malformations using cone beam computed tomography.
The aim of this study was to propose a classification for unilateral cleft lip and palate (UCLP) malformations based on cone beam computed tomography (CBCT) images, as well as to estimate the amount of bone necessary for grafting, and to evaluate the relationship of this volume with scores obtained using the classification. CBCT images of 33 subjects with UCLP were evaluated according to gap, arch, nasal, and dental parameters (GAND classification). Additionally, these defects were segmented and the amount of graft needed for alveolar bone grafting was estimated. The reproducibility of GAND classification was analyzed by weighted kappa test. The association of volume assessment with the classification (gap and nasal parameters) was verified using analysis of variance, while the intra-observer agreement was analyzed using the intra-class correlation coefficient. The intra-observer reproducibility of the classification ranged from 0.29 to 0.92 and the inter-observer agreement ranged from 0.29 to 0.91. There were no statistically significant values when evaluating the association of the volume with the classification (P>0.05). The GAND classification is a novel system that allows the quick estimation of the extent and complexity of the cleft. It is not possible to estimate the amount of bone needed for alveolar bone grafting based on the classification; individualized surgical planning should be done for each patient specifically.
Department of Stomatologic Diagnosis, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
G L deR
GL
Barbosa
Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.
O
O
Emodi
Department of Pediatric Dentistry and Orthodontics, Division of Orthodontics, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil.
H
H
Pretti
Department of Surgery, Division of Plastic Surgery, University of Cincinnati, Cincinnati, OH, USA.
J A
JA
van Aalst
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
S M
SM
de Almeida
Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
D A
DA
Tyndall
Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: luiz_pimenta@unc.edu.
L A
LA
Pimenta
D002971:Cleft Lip / Q000145:classification / Q000000981:diagnostic imaging*; D002972:Cleft Palate / Q000145:classification / Q000000981:diagnostic imaging*; D054893:Cone-Beam Computed Tomography; D003724:Dental Arch / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D009666:Nose / Q000002:abnormalities / Q000000981:diagnostic imaging; D015588:Observer Variation; D015203:Reproducibility of Results; D014071:Tooth Abnormalities / Q000145:classification / Q000000981:diagnostic imaging
alveolar bone grafting; cone beam computed tomography; orofacial cleft