Innovative method to assess maxillary arch morphology in oral cleft: 3d-3d superimposition technique

Abstract

This study aimed to analyze the maxillary growth and development of children with oral clefts using the innovative method of 3D-3D superimposition technique. Children with unilateral complete cleft lip (UCL) and unilateral cleft lip and palate (UCLP) participated in the study. The impressions of the dental arches were executed 1 day before and 1 year after lip repair surgery. A 3D laser scanner digitized the dental models and the stereophotogrammetry system software analyzed the 3D-3D superimpositions in two groups of matches (same child, UCL and UCLP) and one group of mismatches (different individuals). The differences were evaluated by Root Mean Square (RMS) and expressed in millimeters (mm). Kruskal-Wallis test followed by post-hoc Dunn test and Mann-Whitney test were assessed to compare the groups (α=5%). RMS was 1.34 mm (± 0.37) in UCL group, 1.41 mm (± 0.32) in UCLP group, and 3.38 mm (± 1.28) in mismatches group. RMS was significantly greater in mismatches than in matches groups (p<0.0001). No statistically significant differences occurred between genders. The 3D-3D superimposition technique showed the maxillary development after lip repair surgery in the anterior region of the palate. Thus, it is suggested that the cleft amplitude and the palatal segments proportion influenced the morphological heterogeneity and, consequently, the development and maxillary growth of children with orofacial cleft.

Digital Workflow in the Analysis of Orofacial Cleft in Children: Case Series with 5 Years of Follow-Up

“…The superimposition of 3D images of dental arches will indicate possible growth and development areas after surgery. It is worth highlighting that the superimposition provides the link between the theoretical knowledge on palate development and the clinical practice 14,16 . This method will enable that the professional understands better the effects of the rehabilitative treatment and the growth and development changes in palatal bone segments, through a global view of the palatal development.…”

“…Children with UCL, BCL, UCLP and BCLP underwent cheiloplasty. Thus, in these individuals, the dental arches from S2 were superimposed on S1 (Figure 5) 16 .…”

“…In addition, qualitative analysis was performed by chromatic map, in which regions of yellow/red and blue are anatomical points with greater discrepancies between the superimposed surfaces. Green regions shown areas where there was little or no significant change (Figure 5) 16 .…”

Comparative 3D study of dental arches in children with microcephaly associated with congenital Zika syndrome, orofacial cleft, and without craniofacial anomalies

“…The dental casts were digitized by a three-dimensional surface laser scanner (3Shape's R700 Scanner, Copenhagen, Denmark), while the palatal morphometry was analyzed by Mirror imaging software (Canfield Scientific Inc., Fairfield, NJ, USA). 6,7 The following palatal parameters were quantified: intercanine (a transversal line between the eruption points of the primary canine, CC') and intertuberosity distances (a transversal line between the ending of the alveolar edge, TT'), and dental arch length (sagittal line perpendicular to the interincisive point (I) and the intertuberosity distance, ITT'). 6,8,9 These linear measurements were evaluated in millimeters (mm), as in Figure 1A.…”

“…Mismatch superimposition was applied to analyze anatomical differences between participants according to other studies. 7,12,13 Initially, a single palate image from the control group was chosen by random drawing in Microsoft Excel 2019 (Microsoft Corporation, Albuquerque, New Mexico, USA). This dental mold was called "single".…”