Post-surgical effects on the maxillary segments of children with oral clefts: New three-dimensional anthropometric analysis

Abstract

This study aimed to use new three-dimensional (3D) anthropometric analyses to verify the post-surgical effects on the maxillary segments of children with unilateral cleft lip and palate. The sample was composed by digitized dental models of 60 children with unilateral complete cleft lip and alveolus (UCLA) and complete unilateral cleft lip and palate (UCLP). The impressions were taken before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The 3D anthropometric analyses of digitized dental casts were obtained through a specific software. Intragroup changes were applied paired t test and Wilcoxon test (UCLA group) and for the UCLP group, repeated-measures analyses of variance followed by the Tukey test. For intergroup analyses, an independent t test and Mann-Whitney test were used. The palatal dimensional changes of UCLA group showed that the distances IC, I-T', and I-T significantly increased after cheiloplasty (p = 0.0002, p = 0.0007 and p < 0.0001, respectively). In the UCLP group, the IC' distance statistically decreased in the post-surgical periods (p < 0.0001), while the I-T distance increased (p < 0.0001). The IC distance increased after cheiloplasty (p < 0.0001). The I-T' distance increased between T2 and T3 with statistically significant differences (p = 0.0037). The intergroup analysis of palatal development (T2-T1) showed that the distances IC' and I-T' demonstrated a reduction of the dental arches growth of UCLP group compared with the UCLA group, with statistically significant differences. The new 3D anthropometric analysis showed that the development of the maxillary segments changed after surgical repair. The UCLP group demonstrated a reduction of the dental arches growth compared with the UCLA group.

Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition

“…The following linear measurements were analysed: C–C′ (Intercanine distance)—transversal line between the eruption points of the primary canine; T–T′ (Intertuberosity distance)—transversal line between the left and right tuberosity; I–C′ (Left anterior intersegment length)—from the interincisive point to the eruption point of the left primary canine; I–C (Right anterior intersegment length)—from the interincisive point to the eruption point of the right primary canine; I–T′ (Left anteroposterior intersegment length)—from the interincisive point to the left tuberosity; I–T (Right anteroposterior intersegment length) from the interincisive point to the right tuberosity 1‐5,16,17 . The volume of the palatal bone shelves was analysed according to the methodology of the study of Pucciarelli et al, 2015, 18 whereas the area of the palatal bone shelves was evaluated according to Carrara et al, 2016 1 and Ambrosio et al, 2018 2 (Figure 1).…”

Avaliação morfométrica 3D dos arcos dentários de crianças com fissura labiopalatina operados por diferentes técnicas cirúrgicas

“…Os modelos passaram por um processo de digitalização por meio do Scanner 3D (3Shape's R700 TM Scanner), acoplado a um computador. Os modelos foram fielmente digitalizados e as medidas foram obtidas pelo software do sistema de estereofotogrametria (Mirror imaging software, Canfield Scientific Inc., Fairfield, NJ, USA) (Menezes et al, 2016;Sforza et al, 2012, Ambrosio et al, 2018a, Ambrosio et al,2018b.…”

“…Na digitalização de imagens tridimensionais foi utilizado o Scanner 3D (3Shape's R700 TM Scanner) (FERNANDES et al, 2015;CARRARA et al, 2016;FALZONI et al, 2016;JORGE et al, 2016;AMBROSIO et al, 2018a, AMBROSIO et al,2018b. Esse método de obtenção de imagens possui vantagens por não gerar degradação da documentação, nem a necessidade de um depósito físico, os dados são armazenados vinculados a um sistema integrado de instituições de saúde que permite compartilhamento entre profissionais de outros centros de reabilitação e possibilita a troca de experiências sobre diferentes abordagens terapêuticas (SFORZA et al, 2012;DE MENEZES et al, 2016;FALZONI et al, 2016).…”

“…O uso de marcações anatômicas foi o parâmetro de escolha para análise antropométrica dos arcos dentários de crianças com fissura labiopalatinas, assim como vários estudos prévios na literatura (SFORZA et al, 2012;REISER;SKOOG;ANDLIN-SOBOCKI, 2013;ROUSSEAU et al, 2013, FERNANDES et al, 2015, FALZONI et al, 2016HOFFMANNOVA et al, 2016;JORGE et al, 2016;AMBROSIO et al, 2018a;AMBROSIO et al, 2018b;BRUGGINK et al, 2019). É importante ressaltar que a alta resolução, a possibilidade de rotação e ampliação do modelo digitalizado no software de medição e habilidade do examinador, auxiliam no processo de demarcação das estruturas anatômicas (SECKEL et al, 1995).…”

“…A análise dos modelos dentários por meio de pontos anatômicos préestabelecidos nas imagens tridimensionais tem sido usado na avaliação de indivíduos com fissura labiopalatina (MIKOYA et al, 2015, LIPPOLD et al, 2015RUSSEL et al, 2015;ZHU et al, 2016;CODARI et al, 2016, FALZONI et al, 2016SAKODA et al, 2017, AMBROSIO et al, 2018a, AMBROSIO et al, 2018bBRUGGINK et al, 2019;KONGPRASERT et al, 2019…”