3-dimensional analysis of cleft palate casts

It is the aim of presurgical infant orthopedics (PSIO) to reduce the width of the cleft and to achieve optimal alignment of the cleft palate segments within the first few months of infancy prior to any surgical cleft closure. The question about the amount that PSIO can stimulate and steer the growth of the maxilla using a Hotz and Gnoinski passive appliance has not yet bee n satisfactorily answered. In this study, a 3-dimensional digital computer- aided procedure was developed to analyze metrically and to visualize the gr owth of the edentulous maxilla of cleft lip and palate in infants. In a pil ot study, a series of digital scans of consecutive plaster casts was carrie d out. 5 infants with complete unilateral cleft lip and palate (UCLP), who had been treated with passive appliances were evaluated. Impressions were t aken at the age of one week and after 3, 6 and 12 months. Following digitiz ing, the casts were computer-reconstructed and segmented perpendicular to t he alveolar crest, the reference points being C1, C1', C2, C2' and I. The v olume of the resulting segments was ascertained. Computer superimposition o f reconstructed consecutive casts was employed to facilitate a visualizatio n of the extent and direction of morphological changes. Our first results h ave shown that with our method it is possible to quantify the growth rate o f defined segments of the maxilla. The 3-dimensional analysis presented her e will be the basis for further studies to objectify PSIO.