Objectives: To compare the agreement, reliability and convergent validity of the five‐point ordinal Likert scale and a 100 mm visual analog scale (VAS) for three‐dimensional (3D) esthetic assessment of primary unilateral cleft lip repair using a counterbalanced crossover design. Materials and Methods: Fifty lay observers (25 males, 25 females) evaluated 3D stereophotogrammetric facial models of 10 children with nonsyndromic unilateral cleft lip and palate at three time points: preoperative (T0), 1‐month postoperative (T1), and 6‐months postoperative (T2). Nine morphological items were assessed using both the five‐point Likert scale and a 100 mm VAS. A counterbalanced crossover design with a 2‐week washout period and inversion of scale order was implemented to minimize recall and order effects. Pairwise agreement analyses between the categorized VAS and the five‐point Likert scale (interscale, test–retest, presentation‐mode, and longitudinal agreement) were assessed using Cohen’s kappa ( κ ). Overall inter‐rater reliability was evaluated using the intraclass correlation coefficient (ICC), while convergent validity between the categorized VAS and the five‐point Likert scale was assessed using Spearman’s rank correlation coefficient. Results: Pairwise agreement between the categorized VAS and the five‐point Likert scale ranged from κ = 0.54 to κ = 0.80, indicating moderate‐to‐substantial agreement. Overall inter‐rater reliability was excellent for both instruments (ICC = 0.849–0.982). Test–retest agreement was slight to fair ( κ = −0.05 to 0.49), while agreement between full‐face and cropped image presentation was generally limited ( κ = −0.01 to 0.43). Longitudinal agreement across surgical stages was uniformly slight ( κ = −0.05 to 0.18), reflecting expected changes in postoperative morphology rather than measurement instability. Convergent validity between the categorized VAS and the five‐point Likert scale was excellent (Spearman’s ρ = 0.948–0.974; all p < 0.001). Subgroup analyses by evaluator sex and cleft index revealed no consistent patterns. Conclusions: Both the five‐point Likert scale and the VAS demonstrated excellent overall inter‐rater reliability and excellent convergent validity. However, because agreement analyses required categorization of the continuous VAS, the present findings do not establish whether preservation of its continuous measurement properties would provide additional discriminatory capability. Clinical Relevance: For 3D esthetic assessment of primary unilateral cleft lip repair, both the five‐point Likert scale and the VAS provide reliable group‐level evaluations. Standardized image presentation protocols and the use of multiple evaluators are recommended to improve the consistency of esthetic auditing.

Background/Objectives: This study aimed to describe and quantify facial soft tissue changes in two patients who underwent radiotherapy (RT) for head and neck cancers, using three-dimensional (3D) stereophotogrammetry and surface deviation analysis. The aims were (i) to assess the progression of morphological alterations over time (ii) and to evaluate the clinical potential of 3D surface mapping in documenting RT-related aesthetic changes. Methods: Two patients with head and neck cancer undergoing RT were analyzed using three-dimensional stereophotogrammetry (3dMD Trio-system, Atlanta, GA, USA) at three timepoints: before RT (T0), 45 days after the start of RT (T1), and 6 months after the start of RT (T2). Facial 3D scans were processed using Geomagic Control 2014 software (v.3D Systems, Morrisville, NC, USA) to perform standardized alignments and calculate volumetric deviations, create colorimetric deviation maps, and conduct Root Mean Square (RMS) analysis. Results: Between T0 and T1, both patients showed soft tissue volume reduction, primarily in the mandibular and submental regions, likely reflecting acute treatment effects and weight loss. Between T0 and T2, an increase in soft tissue volume was observed, especially in the lower face and neck, consistent with late radiation effects such as lymphedema and post-treatment weight gain. RMS values ranged from 5.53 mm to 6.87 mm across patients and time points, indicating measurable morphological changes. The upper third of the face remained stable and served as a reliable reference region for alignment. Conclusions: RT may be associated with significant, region-specific changes in facial and cervical soft tissues in HNC patients, but these preliminary observations must always be correlated with weight loss and confirmed by further studies. 3D stereophotogrammetry is a reliable, non-invasive method for detecting and quantifying these alterations over time. This technique can offer valuable insights for clinical monitoring and could promote better patient counseling and potentially mitigate the psychological burden associated with facial changes.

Introduction: Infantile Refsum disease (IRD) is considered one of the milder phenotypes within the Zellweger Spectrum Disorders (ZSDs), a group of peroxisomal biogenesis disorders characterized by a generalized impairment of peroxisomal function. Pathognomonic features of IRD are growth retardation, hearing and cognitive impairment, neuromuscular problems, and craniofacial anomalies. Due to the relatively short lifespan, severe dental anomalies have not been previously reported in association with this disorder. This case report describes a rare manifestation of multiple impacted teeth and near complete edentulism in an adult patient diagnosed with Infantile Refsum disease (IRD). Material and Methods: The patient, a 24-year-old female, presented with a skeletal Class III malocclusion, severe maxillary hypoplasia, and complete impaction of the permanent dentition. The diagnosis of Infantile Refsum disease (IRD) was genetically confirmed and was associated with both neurological and dermatological manifestations. Conclusions: This case underscores that severe disturbances in tooth eruption and impaction may represent underrecognized manifestations of metabolic and genetic disorders such as Infantile Refsum disease (IRD). Dental professionals should remain vigilant to the potential association between systemic conditions and delayed or failed tooth eruption, emphasizing the need for interdisciplinary management and further investigation.