As advancements in digital technologies reshape the modern healthcare, integrating digital impression techniques, such as intraoral 3D scanning and 3D analysis and treatment planning, is becoming increasingly essential in the standard care of infants with cleft lip and palate. This study introduces a novel digital measurement method designed specifically for analyzing digital models of infants with unilateral cleft lip and palate, utilizing OnyxCeph3™ software within the interdisciplinary framework of the Frankfurt approach. To support its integration into routine clinical practice, we outlined the complete digital workflow—from data acquisition through intraoral 3D scanning to model preparation and processing. Our method involves precise anatomical and constructed measurement points and diverse distances and angles to evaluate sagittal, transverse, and vertical parameters comprehensively. By leveraging OnyxCeph3™ software for computer-aided measurements of digital 3D models, this approach aims to enhance the accuracy and efficiency of cleft treatment planning, facilitating more informed, personalized care decisions and ultimately improving patient outcomes.
Purpose: The aim of the study was to identify the best prediction model for the growth pattern of the maxillary segments of infants with unilateral cleft lip and palate post birth and prior to the primary surgical cleft closure. Materials and methods: 195 digital maxillary models of 50 infants with unilateral cleft lip and palate were collected during their preoperative alveolar molding therapy period. Intraoral scans were taken shortly after birth, at the monthly checkups and just before the surgical cleft closure at approximately 6 months of age. Surface measurements of maxillary segments were conducted using the diagnostic program OnyxCeph³™. For identifying the best fit for the growth pattern, mixed-effects regression models (fractional polynomials and B-splines) with the surface measurement as dependent variable, patient age (days) as predictor and the patient as random effect were fitted to the data. The best fit was selected according to the Akaike Information Criterium. A likelihood ratio test was performed for comparing the selected model with the intercept-only model. Results: The linear regression with mixed effects model showed the best fit for the total area, the area of the large segment and the area of the small segment. A highly significant association between the surface area and patient age was observed (p < 0.001). An increase of the area with time was estimated at 2.88 mm2 per day for the total area, 1.62 mm2 per day for the area of the large segment and 1.25 mm2 per day for the area of the small segment. The likelihood ratio tests indicated that the linear regression models were significantly better than the intercept-only models for all the measured areas (p < 0.01). Conclusion: The growth pattern for the maxillary segments of patients with unilateral cleft lip and palate in the preoperative period can be best predicted by using a linear regression model. The growth curve model developed by the present study can be used in future treatment planning of patients with unilateral cleft lip and palate.
Background and Objectives: Patients with unilateral cleft lip and palate (UCLP) require a phase of infant orthopedic treatment prior to surgical cleft closure. Treatment planning in this phase necessitates a thorough understanding of maxillary growth dynamics in this period. The aim of the present study was to evaluate the quantitative and qualitative surface growth of maxillary segments in infants with UCLP. Materials and Methods: In total, 195 intraoral scans from 50 patients were obtained postnatal (T0), at monthly intervals (T1–5), and prior to surgical cleft closure at 6 months of age (T6). Surface, linear, and angle measurements of the maxillary segments were performed. Results: Significant increases in the total surface area and the surface areas of the small and large segments were observed at monthly intervals and over the overall duration. The large segment showed greater absolute growth (11.62 mm2 per month, 46.57 mm2 total), while the small segment had a higher percentage increase (1.49% monthly, 6.57% overall). A positive small correlation was observed between surface area growth changes in the small segment and its increase in length. Conclusions: Our results revealed distinct growth patterns of the large and small segments in amount and direction, underscoring the relevance of incorporating segment arch width in surface evaluations.