Three-dimensional imaging methods for quantitative analysis of facial soft tissues and skeletal morphology in patients with orofacial clefts: a systematic review.

PLoS One. 2014 Apr 7;9(4):e93442. doi: 10.1371/journal.pone.0093442. eCollection 2014.

Kuijpers MA(1), Chiu YT(2), Nada RM(3), Carels CE(1), Fudalej PS(4).

Author information:

(1)Department of Orthodontics and Craniofacial Biology, Radboud University

Medical Centre, Nijmegen, the Netherlands; Cleft Palate Craniofacial Unit,

Radboud University Medical Centre, Nijmegen, The Netherlands.

(2)Department of Dentistry and Craniofacial Center, Chang Gung Memorial

Hospital, Taipei, Taiwan.

(3)Department of Orthodontics and Craniofacial Biology, Radboud University

Medical Centre, Nijmegen, the Netherlands.

(4)Department of Orthodontics and Craniofacial Biology, Radboud University

Medical Centre, Nijmegen, the Netherlands; Department of Orthodontics and

Dentofacial Orthopedics, University of Bern, Bern Switzerland; Department of

Orthodontics, Palacky University Olomouc, Olomouc, Czech Republic.

BACKGROUND: Current guidelines for evaluating cleft palate treatments are mostly

based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging

methods to assess treatment outcome are steadily rising.

OBJECTIVE: To identify 3D imaging methods for quantitative assessment of soft

tissue and skeletal morphology in patients with cleft lip and palate.

DATA SOURCES: Literature was searched using PubMed (1948-2012), EMBASE

(1980-2012), Scopus (2004-2012), Web of Science (1945-2012), and the Cochrane

Library. The last search was performed September 30, 2012. Reference lists were

hand searched for potentially eligible studies. There was no language restriction.

STUDY SELECTION: We included publications using 3D imaging techniques to assess

facial soft tissue or skeletal morphology in patients older than 5 years with a

cleft lip with/or without cleft palate. We reviewed studies involving the facial

region when at least 10 subjects in the sample size had at least one cleft type.

Only primary publications were included.

DATA EXTRACTION: Independent extraction of data and quality assessments were

performed by two observers.

RESULTS: Five hundred full text publications were retrieved, 144 met the

inclusion criteria, with 63 high quality studies. There were differences in

study designs, topics studied, patient characteristics, and success

measurements; therefore, only a systematic review could be conducted. Main

3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI,

stereophotogrammetry, and laser surface scanning. These techniques are mainly

used for soft tissue analysis, evaluation of bone grafting, and changes in the

craniofacial skeleton. Digital dental casts are used to evaluate treatment and

changes over time.

CONCLUSION: Available evidence implies that 3D imaging methods can be used for

documentation of CLP patients. No data are available yet showing that 3D methods

are more informative than conventional 2D methods. Further research is warranted

to elucidate it.

DOI: 10.1371/journal.pone.0093442

PMCID: PMC3977868

PMID: 24710215 [Indexed for MEDLINE]

Conflict of interest statement: Competing Interests: The authors have declared

that no competing interests exist.