Abstract
Objective:To validate a newly developed method for capturing 3-dimensional (3D) images of the nasolabial region for assessing upper lip scarring and asymmetry in surgically managed unilateral cleft lip and palate (UCLP) cases.Design:Validation study, single cohort.Materials and Methods:Eighteen surgically managed UCLP cases were recruited, the nasolabial region of each face was scanned using an intraoral scanner (IOS) to produce 3D images. The images were manually segmented to allow the calculation of surface area of the scar and upper lip asymmetry. Five professionals and 5 lay assessors subjectively evaluated the same images and graded the upper lip scarring and asymmetry at 2 separate occasions. The relationship between the subjective and objective assessments was evaluated.Results:Moderate correlation was found between subjective and objective evaluations of the upper lip scarring and total asymmetry. The captured 3D images were of good quality for the objective measurements of lip asymmetry and residual scarring. Moderate to strong correlations were detected between the 2 panels (T ranging between 0.5 and 0.9) with no significant difference (P > .05) in the mean score of the subjectively evaluated parameters.Conclusion:The IOS is a useful tool for the capture of the nasolabial morphology. The captured 3D images are a reliable source for measuring lip asymmetry and scar surface area. The method has sufficient validity for routine clinical use and for objective outcome measures of the surgical repair of cleft lip.
Highlights
The evaluation of facial appearance of the unilateral cleft lip and palate (UCLP) has been considered both qualitatively and quantitatively (Al-Omari et al, 2015, Thierens et al, 2018)
Various 3D imaging methods were used for capturing the orofacial morphology for the quantitative analysis and characterization of the cleftrelated facial deformity, which include computed tomography scans (CT), cone beam CTs (CBCT), magnetic resonance imaging (MRI), stereophotogrammetry, structured light surface scanning, and laser surface scanning technologies (Brons et al, 2012; Kuijpers et al, 2014; Awarun et al, 2019)
The capture of the nasolabial region with intraoral scanner (IOS) was readily achievable with minimal discomfort using a non-invasive method
Summary
The evaluation of facial appearance of the unilateral cleft lip and palate (UCLP) has been considered both qualitatively and quantitatively (Al-Omari et al, 2015, Thierens et al, 2018). Liu et al (2019) reported on the fabrication of orbital prostheses using the images generated by IOS This method entails capturing the healthy eye, creating a mirror copy of the image to reconstruct the defect on the contralateral side. The authors argued IOS could produce a better 3D model of the ear than the other imaging technologies because of the high level of accuracy in recording the complex anatomy of this region with multiple anatomical undercuts They concluded that the application of IOS for maxillofacial imaging achieved excellent outcome, eliminated the need for manual sculpting, and is more time-efficient in comparison to the conventional methods. The IOS has not yet been applied to the recording of facial morphology or the nasolabial region in CLP cases
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