Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study

Abstract

The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically repaired UCLP, who met the inclusion criteria, were selected. Following the acquisition of CBCT scans, fourteen bilateral landmarks were selected. The distance of the bilateral landmark was calculated from the midsagittal plane on the cleft and non-cleft sides for both frontal and axial views. Tracings were done;the data obtained was subjected to statistical analysis;and intra-observer variability was checked with intraclass correlation coefficient (ICC) and two-way ANOVA. Subsequently, the measurements were subjected to paired t-tests at the 95% level of significance with Bonferroni correction. A significant reduction of pyriforme and an alveolar crest above the maxillary 1st molar were discerned in frontal analysis on the cleft side. In the axial view, the zygomatic arch, malar, porion and alveolar crest at the molar region were non-significant, but the alveolar crest at the premolar region (p < 0.004)) was significantly decreased. In the frontal analysis, pyriforme and the alveolar crest above the maxillary 1st molar, and, in the axial view, premolar widths, showed significant reduction when comparing the cleft vis-a-vis non-cleft sides.

Morphometric Analysis of the Mandibular Canal, Anterior Loop, and Mental Foramen: A Cone-Beam Computed Tomography Evaluation

“…Orthopantomogram was recommended as an initial investigation to predict IAN injuries following extraction surgery for lower impacted wisdom teeth while CBCT scans were considered by many practitioners as a keystone in pre-implantation assessment to plan minimally invasive surgery, conduct mocks for planned surgeries, and avoid iatrogenic injuries [ 39 , 40 ]. Also, CBCT can be used to assess the skeletal deformation in congenital diseases [ 41 ] This study emphasizes the importance of using the appropriate imaging modality on an individual basis to locate these structures before performing implantation or other surgical procedures related to the mandible. Furthermore, population-specific data are important, since the use of standards proposed for other populations reported in textbooks or journals can result in serious injuries and/or reduce the management efficacy.…”

Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms

“…CBCT scans had been acquired using an i-CAT next-generation machine (Imaging Sciences International, Hatfield, PA, USA) with a field of view (fov) of 17 × 22 cm and a scan time of 26 s. The data gathered were saved in DICOM (version 1.7) format with an isometric voxel size of 0.25 mm. The DICOM images, using InVivoDental 5.0 (Anatomage, anatomy imaging software, San Jose, CA, USA), were reoriented according to Kochhar et al [ 25 ]. According to a recent study, the precision of landmark plotting is negligibly affected by the orientation of CBCT images, but for the current study, reoriented images were utilized [ 2 ].…”

“…For impeccable treatment planning, the reliability and reproducibility of these anatomical landmarks are imperative, especially in patients with CLP where the identification of landmarks is highly challenging and, therefore, difficult to perceive and reproduce. Although the synchronal literature in the past several years has emphasized the pivotal role of CBCT to determine the reliability [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ] of anatomic landmarks, there is a paucity of studies for the same, along with their reproducibility in CLP patients versus cephalometrics where the localization of anatomy is challenging.…”

Intra- and Interobserver Reliability of Bone Volume Estimation Using OsiriX Software in Patients with Cleft Lip and Palate Using Cone Beam Computed Tomography

“…Volume rotated mediolaterally until the transporionic line of the data became horizontal. Volume rotated until the midsagittal plane of the data oriented vertically, and in sagittal view, the Frankfort plane of the data was oriented horizontally [ 9 ]. After orientation, new volumes were acquired and saved.…”

“…A prerequisite for SABG procedure is a precise assessment of the alveolar defect volume. It helps in procedure preparation, for example, donor site selection and treatment outcome evaluation [ 8 , 9 , 10 ]. Formerly, the only methods available for alveolar cleft evaluation were conventional two-dimensional (2D) radiography; linear measurements; and subjective evaluations of panoramic, occlusal, and periapical radiographs [ 11 , 12 ].…”