Precision of Landmark Positioning on Digitized Models from Patients with Cleft Lip and Palate

Jakob Brief; Jan H. Behle; Angelika Stellzig-Eisenhauer; Stefan Hassfeld

doi:10.1597/04-106.1

Precision of Landmark Positioning on Digitized Models from Patients with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/04-106.1 ◽

2006 ◽

Vol 43 (2) ◽

pp. 168-173 ◽

Cited By ~ 12

Author(s):

Jakob Brief ◽

Jan H. Behle ◽

Angelika Stellzig-Eisenhauer ◽

Stefan Hassfeld

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Plaster Cast ◽

Anatomical Landmarks ◽

Positioning Error ◽

The University ◽

Plaster Models ◽

The Ideal

Objective To quantify the precision of landmark positioning on digitized casts of patients with unilateral cleft lip and palate. Patients Forty plaster models of newborns up to 8 months of age were selected from the archive of the Department of Orthodontics of the University of Heidelberg. Material and Method The plaster-cast models were digitized with a Micromeasure 70 three-dimensional laser scanner (Micromeasure, Bischoffen, Germany). The laser scanner used in this study operates with a precision of 0.15 mm on the x- and y-axes and 0.06 mm on the z-axis. In the intraobserver study, a single observer placed anatomical landmarks in four rounds, with at least 4 weeks between each round. In the interobserver study, four different observers each placed the same landmarks once. For the two different studies, an ideal location for each landmark was calculated by averaging the landmark positions of the four rounds or observers. The distance between each of the four landmark positions and the ideal landmark was measured. Results A 95% confidence interval for the landmark positioning error was calculated. For the intraobserver investigation, this error was 0.34 to 1.30 mm, and for the interobserver investigation it was 0.7 to 2.00 mm. Conclusion Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.

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Three-dimensional laser scanner evaluation of facial soft tissue changes after LeFort I advancement and rhinoplasty surgery: patients with cleft lip and palate vs patients with nonclefted maxillary retrognathic dysplasia (control group)

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2013.12.406 ◽

2014 ◽

Vol 117 (4) ◽

pp. 416-423 ◽

Cited By ~ 8

Author(s):

Laura Verzé ◽

Francesca Antonella Bianchi ◽

Guglielmo Ramieri

Keyword(s):

Soft Tissue ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Control Group ◽

Facial Soft Tissue ◽

Tissue Changes ◽

Soft Tissue Changes

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Three-Dimensional Analysis of Morphological Changes in the Maxilla of Patients with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0001_tdaomc_2.0.co_2 ◽

2002 ◽

Vol 39 (1) ◽

pp. 1-11 ◽

Cited By ~ 11

Author(s):

Bert Braumann ◽

Ludger Keilig ◽

Christoph Bourauel ◽

Andreas Jäger

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Morphological Changes ◽

Three Dimensional ◽

Laser Scanner ◽

Computer Software ◽

Reference Points ◽

Starting Point ◽

Ideal Tool ◽

Infant Orthopedics

Objective Three-dimensional (3-D) morphological changes in the maxilla of patients with cleft lip and palate (CLP) have been recorded, mainly using two-dimensional cast analyses. Although these seem to be insufficient, no standardized 3-D method has been developed until now. In this study, accuracy, precision, and validity of a newly developed 3-D digital computer-aided procedure to visualize and metrically analyze the growth of the edentulous maxilla of infants with CLP have been evaluated. Patients The method was applied to 10 infants with complete unilateral CLP. Interventions Consecutive casts of the maxilla (1 week and 3, 6, and 12 months) of each patient were optically measured with a 3-D laser scanner. Following digitizing, the casts were computer reconstructed, aligned, and superimposed using specialized computer software. The distances between the surfaces were measured. Additionally, the surfaces were segmented perpendicular to the alveolar crest, the reference points being C1, C1′, C2, C2′, and I. The volumes of the resulting segments were determined and compared with one another. Results The newly developed analysis enables a visualization of the extent and direction of morphological changes in the maxilla of infants with CLP. With this method it is possible to quantify these changes of the volume of defined alveolar segments. Conclusions The 3-D analysis developed is an ideal tool for the examination of 3-D morphological changes in the edentulous maxilla of patients with CLP. The results will serve as the starting point for a longitudinal study on the efficacy of different methods, not only of presurgical infant orthopedics but also of surgical procedures.

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Influence of Early Hard Palate Closure in Unilateral and Bilateral Cleft Lip and Palate on Maxillary Transverse Growth during the First Four Years of Age

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2003_040_0126_ioehpc_2.0.co_2 ◽

2003 ◽

Vol 40 (2) ◽

pp. 126-130 ◽

Cited By ~ 3

Author(s):

Bernhard Lehner ◽

Joerg Wiltfang ◽

Karin Strobel-Schwarthoff ◽

Michaela Benz ◽

Ursula Hirschfelder ◽

...

Keyword(s):

Hard Palate ◽

Primary Closure ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Arch Width ◽

Significant Difference ◽

Early Primary ◽

Delayed Closure ◽

The University

Objective To evaluate and compare the effects of early primary closure of the hard palate on the anterior and posterior width of the maxillary arch in children with bilateral (BCLP) and unilateral (UCLP) cleft lip and palate during the first 4 years of life. Design A retrospective, mixed-longitudinal study. Setting Cleft Palate Center of the University of Erlangen-Nuremberg. Subjects and Methods The present investigation analyzes longitudinally 42 children with UCLP and 8 children with BCLP between 1996 and 2000 with early simultaneous primary closure of lip and hard palate (4 to 5 months). Palatal arch width was measured on dental casts with a computer-controlled three-dimensional digitizing system, and their growth velocities were calculated from consecutive periods (mean follow-up 39 months). Differences in growth velocities were compared with those of 25 children with UCLP and 15 children with BCLP with delayed closure of hard palate (12 to 14 months). Results and Conclusions There was no significant difference in terms of anterior and posterior maxillary width between early and delayed closure of hard palate within the first 4 years of life.

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A Longitudinal Study on Influence of Primary Facial Deformities on Maxillofacial Growth in Patients with Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-151.1 ◽

2005 ◽

Vol 42 (6) ◽

pp. 633-640 ◽

Cited By ~ 31

Author(s):

Norifumi Nakamura ◽

Akira Suzuki ◽

Hideki Takahashi ◽

Yasuo Honda ◽

Masaaki Sasaguri ◽

...

Keyword(s):

Surface Area ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Total Surface Area ◽

3D Analysis ◽

Alar Base ◽

Angular Measurements ◽

Ocular Hypertelorism

Objective The goal of this study was to use three-dimensional (3D) analysis to characterize the primary facial deformities in children with unilateral cleft lip and palate (UCLP) and then serially analyze the relationships between facial deformities and maxillofacial growth from infancy to adolescence. Participants Twenty-one Japanese subjects with unilateral cleft lip and alveolus (UCLA) and 20 with UCLP who had been operated on and then followed up for more than 15 years were enrolled in this study. Main Outcome Measures Facial cast models taken at cheiloplasty were scanned with a 3D laser scanner. Lateral cephalographs taken when subjects were 15 years of age or older were traced, and linear and angular measurements were calculated. The correlation between primary facial forms and maxillofacial morphology in adolescence was analyzed. Results Three-dimensional analysis showed larger ocular hypertelorism, wider cleft, greater deviation of the columella base, and more severe retruded position of the affected nasal alar base in subjects with UCLP than those with UCLA. Total surface area of the upper lips in subjects with UCLP was significantly smaller than those with UCLA. Correlation analyses revealed that the width of cleft lip, deviation of the columella base, difference of the nose base width, and surface area of the upper lip were statistically correlated with the maxillary length, the anterior position of the maxillary alveolar base, the posterior facial height, and the high angle of the mandible. Conclusion The subjects who had less severe facial deformities and more tissue volume of the upper lips at cheiloplasty showed better maxillofacial growth.

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Reliability of Linear Measurements on a Virtual Bilateral Cleft Lip and Palate Model

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-078 ◽

2006 ◽

Vol 43 (5) ◽

pp. 519-523 ◽

Cited By ~ 9

Author(s):

Barbara C. M. Oosterkamp ◽

Wicher J. van der Meer ◽

Majelle Rutenfrans ◽

Pieter U. Dijkstra

Keyword(s):

Reference Point ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Plaster Cast ◽

Reference Points ◽

Virtual Model ◽

Linear Measurements ◽

Bilateral Cleft Lip ◽

Top View

Objective: To assess the reliability and validity of measurements performed on three-dimensional virtual models of neonatal bilateral cleft lip and palate patients, compared with measurements performed on plaster cast models. Materials and Methods: Ten high-quality plaster cast models of bilateral cleft lip and palate patients were scanned with an LDI-scanner to obtain a three-dimensional virtual model. Linear measurements were performed on the plaster cast models using a digital caliper and also on the three-dimensional virtual model using Viscam RP version 2.1 software. The measurements were performed by two observers on two occasions. Results: Intraclass correlations ranging from .81 to .96 were found for all measurements except the measurement between the constructed reference point pr and reference point i (intraclass correlation = .40). A post hoc procedure in which top-view screen prints of the three-dimensional virtual model were used to perform the measurement between reference points pr and i demonstrated an intraclass coefficient of .90. Conclusions: Three-dimensional virtual models obtained by laser scanning neonatal cast models of bilateral cleft lip and palate patients can be used reliably and validly to perform linear measurements between existing reference points on the surface of the model using Viscam RP version 2.1 software. Measurements between reference points constructed outside the surface of the model cannot be validly performed on the three-dimensional virtual model with the software used in this study. For these measurements, top-view screen prints of the three-dimensional virtual model can be used.

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Patterns of Maxillary Alveolar Arch Growth Changes of Infants with Unilateral Cleft Lip and Palate: Preliminary Findings

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2003_040_0363_pomaag_2.0.co_2 ◽

2003 ◽

Vol 40 (4) ◽

pp. 363-372 ◽

Cited By ~ 4

Author(s):

Bert Braumann ◽

Ludger Keilig ◽

Angelika Stellzig-Eisenhauer ◽

Christoph Bourauel ◽

Stefaan Bergé ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

First Year ◽

Osteoplastic Surgery ◽

Growth Changes ◽

Crest Length ◽

First Year Of Life

Objective Because of significant differences in pathomorphology at birth, it may be that a better treatment outcome prognosis exists for patients with incomplete versus complete cleft forms. Can reaction patterns be extracted from changes in maxillary dimensions of different cleft forms within the first year of life to support this hypothesis? Subjects Chronologically consecutive casts of the maxilla (1 week and 3, 6, and 12 months of life) of 15 patients with complete unilateral cleft lip and palate (cUCLP) and 13 patients with incomplete unilateral cleft lip and palate (iUCLP). All patients were treated with passive palatal plates. Cheiloplasty was performed at 6 months of age. No primary osteoplastic surgery was carried out. Interventions Following digitizing with a three-dimensional laser scanner, all cast surfaces were computer reconstructed, aligned, and superimposed. Distances between the surfaces were determined and expressed graphically. Computer-aided determination of defined maxillary dimensions was performed. The volumes of segmented surfaces were determined and compared. Results Within the first year of life, decreased sagittal but increased transverse alveolar growth for patients with iUCLP was found. The increase in alveolar crest length in patients with iUCLP was 50% less within the first year of life than in patients with cUCLP. In the same patients, the volumes of the molar segments were, on average, larger at each registration stage and the increase in these volumes larger within the first year of life. Conclusion Conclusions regarding the direction and extent of growth cannot be drawn from the visible level of severity of the malformation.

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Dentoalveolar Growth of Patients with Complete Unilateral Cleft Lip and Palate by Early Two-Stage Furlow and Push-Back Method: Preliminary Results

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-020.1 ◽

2004 ◽

Vol 41 (5) ◽

pp. 519-525 ◽

Cited By ~ 23

Author(s):

Taiji Kitagawa ◽

Hiroshi Kohara ◽

Taiji Sohmura ◽

Junzo Takahashi ◽

Takashi Tachimura ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Japanese Patients ◽

Horizontal Direction ◽

Two Stage ◽

Cross Sectional ◽

Growth Changes ◽

Deciduous Molar

Objective This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Subjects Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Method Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. Results In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. Conclusion The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

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Relationship between Primary Palatal Form and Maxillofacial Growth in Japanese Children with Unilateral Cleft Lip and Palate: Infancy to Adolescence

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0527_rbppfa_2.0.co_2 ◽

2002 ◽

Vol 39 (5) ◽

pp. 527-534 ◽

Cited By ~ 11

Author(s):

Yasuo Honda ◽

Akira Suzuki ◽

Norifumi Nakamura ◽

Masamichi Ohishi

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Laser Scanner ◽

Japanese Children ◽

Linear Measurements ◽

Surface Areas ◽

Dental Hospital ◽

The Relationship ◽

Maxillary Defects

Objective: The purpose of this retrospective study was to evaluate the relationship between the severity of maxillary defects and maxillofacial growth from infancy to adolescence in children with complete unilateral cleft lip and palate (UCLP). Subjects: Thirty-one Japanese children with UCLP who had received cheiloplasty, palatoplasty, and orthodontic treatments at the Kyushu University Dental Hospital were selected. Materials and Methods: A three-dimensional laser scanner was used to measure maxillary dental casts taken at cheiloplasty. Surface areas and volumes of the palatal tissue were calculated. Lateral cephalographs that were taken both at cheiloplasty and 15 years of age or over (average age 16.5 years) were traced and digitized. Angular and linear measurements were calculated from the x, y-coordinates. Using correlation analyses, defects in the palatal tissue were compared with maxillofacial morphology both at cheiloplasty and in adolescence or maxillofacial growth during that time span. Results: (1) The surface areas or volumes of the palatal tissue were significantly correlated with the following maxillofacial measurements at infancy and adolescence: Or-depth; A-depth; PNS-height; ANS-height; N-Ba; S-N; S-Ba; N to P.P; A'-Ptm’; Cd-Pog; Cd-Gn; Cd-G; and the N-S-Ba, S-N-A, and A-N-B angles. (2) They were also significantly correlated with the following maxillofacial growth measures from infancy to adolescence: A-depth, S-Ba, and the N-S-Ba and S-N-A angles. Only the N-S-Ba angle showed a negative correlation. Conclusion: The patient who had more palatal tissue at cheiloplasty showed better maxillofacial growth.

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