Novel Three-Dimensional Understanding of Maxillary Cleft Distraction

Novel Three-Dimensional Understanding of Maxillary Cleft Distraction:

Journal of Craniofacial Surgery:

September 2016 - Volume 27 - Issue 6 - p 1462–1464

doi: 10.1097/SCS.0000000000002772

Original Articles

Novel Three-Dimensional Understanding of Maxillary Cleft Distraction

Vaughan, Stephen Michael DMD; Kau, Chung How DDS, PhD; Waite, Peter Daniel DDS, MD

Supplemental Author Material

Abstract

Objectives: To set forth a universal standard methodology for quantifying volumetric and linear changes in the craniofacial complex, utilizing three-dimensional data captured from a cleft-lip palate patient who underwent rigid external device (RED) distraction.

Methods: Cone beam computed tomography images of a 14-year-old patient were captured using a Kodak 9500 (Atlanta, GA) Cone Beam system device and a stereophotogrammetric system (3dMDface(TM) Atlanta, GA). The subject was a nonsyndromic unilateral cleft-lip palate patient who received RED distraction as part of maxillary advancement in conjunction with orthodontic treatment. Preop (T1) and postop (T2) images were superimposed using Invivo 5.2.3 (San Jose, CA) software. Volumetric rendering of the airway, bone, and soft tissues, as well as linear measurements were analyzed. Each measurement was captured 10 times to ensure reliability and reproducibility of methodology.

Results: Data from T1 to T2 revealed mean differences as follows: airway total volume +5250 mm³, minimum cross-sectional area +67.84 mm²; bone +1719 mm³, soft tissue +44,432 mm³. Mean of linear measurements: Pronasale 1.98 mm, Subnasale 3.35 mm, Labial superius 10.79 mm, Labial inferius 4.13 mm, Right alare 5.71 mm, Right cheilion 7.83 mm, Left alare 4.97 mm, Left cheilion 5.50 mm, Pogonion 3.01 mm, B-point 2.49 mm, U1-U1 9.77 mm, and L1-L1 0.00 mm. P values are <0.001 for each analysis.

Conclusions: This paper represents a novel and innovative way to look at prepost RED distractions in a three-dimensional format. A universal standard analysis of the craniofacial complex can be implemented using the techniques and method outlined in this study.

© 2016 by Mutaz B. Habal, MD.

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