Validation of a vision-based, three-dimensional facial imaging system (original) (raw)
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3D facial morphometry in children with oral clefts
Objectives: The aim of this study was to characterize three-dimensional (3D) facial morphological variation of children with cleft lip and palate compared to an age- and sexmatched control group. Design: Cross-sectional, case-controlled observational morphometric study. Materials and Methods: Subjects were 103 children aged 8 to 12 years old with cleft lip and palate—40 with unilateral cleft lip and palate, 23 with unilateral cleft lip and alveolus, 19 with bilateral cleft lip and palate, and 21 with isolated cleft palate (ICP)—and 80 sex- and age-matched control subjects. Subjects were scanned using 3D stereophotogrammetry. Thirty-nine landmarks were digitized for each scan, and the x, y, and z coordinates for each landmark were extracted. Linear and angular facial measurements were computed. Multivariate analysis of covariance was undertaken to detect significant differences in facial morphometry between the groups. Results: Statistically significant differences (P , .05) were observed between all groups. The greatest morphometrical impact was seen in those groups where both lip and palate were affected and repaired; the group with ICP was the most similar to the control subjects. Conclusions: Significant differences were seen in 3D soft-tissue measurements, mainly in the nasolabial region, between the cleft groups where the lip is affected and the ICP and control group
Three-Dimensional Soft-Tissue Evaluation in Patients with Cleft Lip and Palate
Medical Science Monitor
Departmental sources Background: In cleft lip and palate (CLP) patients, the shape of the facial soft tissues shows variety in 3 dimensions (3D). Two-dimensional (2D) photographs and radiographs are insufficient in the examination of these anomalies. The aim of this retrospective study was to examine the soft tissue and craniofacial characteristics of individuals with nonsyndromic unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), skeletal Class III malocclusions, or skeletal Class I malocclusions using 3D facial imaging. Material/Methods: The entire study group consisted of a total of 158 patients, aged 8-32 years: 29 of the patients had UCLP, 22 BCLP, 54 had skeletal Class III malocclusions, and 53 had skeletal Class I malocclusions. 3D stereophotogrammetric soft-tissue recordings of all patients were analyzed. ANOVA and the Kruskal-Wallis test were performed to compare the groups. Results: Statistically significant differences were observed among the groups in terms of linear, angular, proportional. and volumetric measurements. While nasal differences were not observed in the Class III group, nose and upperlip deformities were common in the CLP groups. Upper-lip projection was reduced in all 3 groups. In the Class III patients, the lower lip and chin were more prominent than in the other groups. The facial convexity angle was increased in the CLP and Class III groups. The upper-lip volume was decreased in the BCLP, the UCLP, and the Class III groups. Conclusions: Patients with skeletal Class III or CLP anomalies showed significantly different soft-tissue characteristics than the Class I control group. 3D stereophotogrammetric facial imaging is an easy and noninvasive method that can be used in examination and recording of these facial deformities. It is possible to make volumetric measurements using this method.
We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra-and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p < 0.0018. Intra-and inter-observers' reliability was considered fair to excellent with an ICC value ranging from 0.54 to 0.99. Statistically significant differences (p < 0.0018) were found mainly in the nasolabial region. The cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions. Surgical repair of cleft lip and palate (CLP) is usually carried out early in life, with cheilorhinoplasty performed at three months of age and palatoplasty accomplished between ages of six months to one year 1. Regardless of the timing of surgery and techniques used, residual deformity and asymmetry around the nasolabial region seems to characterise the facial appearance of CLP patients 2. Among the secondary deformities observed after corrective surgery of CLP are wide alar implantations, short and flat upper lip, hypoplastic maxilla leading to upper lip retru-sion and flat nose 3. These abnormalities have an important influence on facial attractiveness and psychosocial well-being. CLP patients are more shy and socially inhibited when compared with non-cleft individuals. They also reported being teased in their childhood and adolescence; and are often stigmatised in social situations 4. Comprehensive assessment of a multitude of aspects of CLP is essential. Whilst patient satisfaction 5 , psychosocial well-being 6 , speech 7 , and dental arch relationship 8,9 have been thoroughly assessed, evaluation of facial appearance is limited. There is diversity in the assessment of cleft-related deformity and this can be broadly classified into quantitative and qualitative assessment. Qualitative evaluation of nasolabial appearance involves subjective perception of deformity without performing any measurement on the stimulus material, which can range from coloured photographs , projected colour transparencies to on-screen digital photographs 10. Asher-McDade et al. 11 developed a standardised method to assess nasolabial appearance of patients with unilateral cleft lip and palate (UCLP) using standard coloured frontal and lateral photographs. The nasolabial area is rated using a five-point ordinal scale, 1 being very good appearance and 5 being very poor. Although this method is simple and quick, it is also rather subjective and relies heavily on judges' experience and familiarity with the technique. Quantitative analysis of cleft-related deformity involves facial measurements between specified facial landmarks. The anthropometric evaluation can be conducted directly on live subjects 12 or indirectly on plaster casts 13 , two-dimensional (2D) photographs 14 , and three-dimensional (3D) imaging 15–27. While direct subject measurement was thought to be the gold standard, it has many disadvantages which include the fact that it is time consuming , requires significant patient cooperation and poses risks of injury especially when involving measurement
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2015
Three-dimensional surface imaging is an increasingly popular modality for face measurements in infants with cleft lip and palate. Infants are noncompliant toward producing specific facial expressions, and selecting the appropriate moment of acquisition is challenging. The objective was to estimate amount and spatial distribution of deformation of the face due to facial expression in infants with cleft lip and palate and provide recommendations for an improved acquisition protocol, including a method of quality control in terms of obtaining images with true neutral expression. Three-dimensional surface images of ten 4-month-old infants with unrepaired cleft lip and palate were obtained using a 3dMDface stereophotogrammetric system. For each subject, five surface images judged as representing a neutral expression were obtained during the same photo session. Mean and maximum deformations were calculated. A formalized review was performed, allowing the image exhibiting the "bes...
3D imaging in patients with orofacial clefts
2018
Chapter 1 General introduction p. Chapter 2 Three-dimensional imaging methods for quantitative analysis p. of facial soft tissues and skeletal morphology in patients with orofacial clefts: A systematic review.
Dentistry Journal
The applications of computer-guided technologies for three-dimensional image analysis provide a unique opportunity to quantify the morphological dimensional changes of the face in a practical and convenient way. Symmetry of the nasolabial area is one of the main factors of facial attractiveness as well as being the main objective of the treatment of cleft lip and palate (CLP). Technological advances in computer-guided visualization modes and their applications to three-dimensional stereophotogrammetry provide more practical opportunities and alternatives for facial analysis. Each study, however, uses different protocols for the acquisition and analysis of three-dimensional images. In addition, each study identifies different anthropometric points and calculates linear and angular measurements with overlapping protocols. Therefore, it is appropriate to define a standardization of the three-dimensional analysis of CLP patients to compare the studies of different research centers. The ...
PeerJ, 2019
Background Stereophotogrammetry can be used to study facial morphology in both healthy individuals as well as subjects with orofacial clefts because it shows good reliability, ability to capture images rapidly, archival capabilities, and high resolution, and does not require ionizing radiation. This study aimed to compare the three-dimensional (3D) facial morphology of infants born with unilateral cleft lip and palate (UCLP) with an age-matched normative 3D average face before and after primary closure of the lip and soft palate. Methods Thirty infants with a non-syndromic complete unilateral cleft lip, alveolus, and palate participated in the study. Three-dimensional images were acquired at 3, 6, 9, and 12 months of age. All subjects were treated according to the primary surgical protocol consisting of surgical closure of the lip and the soft palate at 6 months of age. Three-dimensional images of UCLP patients at 3, 6 (pre-treatment), 9, and 12 months of age were superimposed on no...
Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts
Journal of applied oral science : revista FOB
The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05). The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control ...
Longitudinal 3D Assessment of Facial Asymmetry in Unilateral Cleft Lip and Palate
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2018
Longitudinal evaluation of asymmetry of the surgically managed unilateral cleft lip and palate (UCLP) to assess the impact of facial growth on facial appearance. Prospective study. Glasgow Dental Hospital and School, University of Glasgow, United Kingdom Patients: Fifteen UCLP infants. The 3-D facial images were captured before surgery, 4 months after surgery, and at 4-year follow-up using stereophotogrammetry. A generic mesh which is a mathematical facial mask that consists of thousands of points (vertices) was conformed on the generated 3-D images. Using Procustean analysis, an average facial mesh was obtained for each age-group. A mirror image of each average mesh was mathematically obtained for the analysis of facial dysmorphology. Facial asymmetry was assessed by measuring the distances between the corresponding vertices of the original and the mirror copy of the conformed meshes, and this was displayed in color-coded map. There was a clear improvement in the facial asymmetry f...
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International journal of oral science, 2012
The repeatability of a non-invasive digital protocol proposed to evaluate the three-dimensional (3D) position of the occlusal plane in the face is assessed. Dental virtual models and soft tissue facial morphology of 20 adult subjects were digitally integrated using a 3D stereophotogrammetric imaging system. The digital 3D coordinates of facial and dental landmarks were obtained by two different operators. Camper's (facial) and occlusal (dental) planes were individuated, and their 3D relationships were measured. The repeatability of the protocol was investigated and showed no significant differences in repeated digitizations. The angle between occlusal and Camper's planes was smaller than 2° in the frontal and horizontal projections. In the sagittal projection, the angle was observed to be, on average, 4.9°. The determined occlusal plane pitch, roll and yaw values show good agreement with previously published data obtained by different protocols. The current non-invasive meth...
Validation of a new three-dimensional imaging system using comparative craniofacial anthropometry
Maxillofacial Plastic and Reconstructive Surgery
Background: The aim of this study is to validate a new three-dimensional craniofacial stereophotogrammetry imaging system (3dMDface) through comparison with manual facial surface anthropometry. The null hypothesis was that there is no difference between craniofacial measurements using anthropometry vs. the 3dMDface system. Methods: Facial images using the new 3dMDface system were taken from six randomly selected subjects, sitting in natural head position, on six separate occasions each 1 week apart, repeated twice at each sitting. Exclusion criteria were excess facial hair, facial piercings and undergoing current dentofacial treatment. 3dMDvultus software allowed facial landmarks to be marked and measurements recorded. The same measurements were taken using manual anthropometry, using soluble eyeliner to pinpoint landmarks, and sliding and spreading callipers and measuring tape to measure distances. The setting for the investigation was a dental teaching hospital and regional (secondary and tertiary care) cleft centre. The main outcome measure was comparison of the craniofacial measurements using the two aforementioned techniques. Results: The results showed good agreement between craniofacial measurements using the 3dMDface system compared with manual anthropometry. For all measurements, except chin height and labial fissure width, there was a greater variability with the manual method compared to 3D assessment. Overall, there was a significantly greater variability in manual compared with 3D assessments (p < 0.02). Conclusions: The 3dMDface system is validated for craniofacial measurements.
Clinical oral investigations, 2018
To assess the influence of involuntary facial expressions on 3D facial stereophotogrammetry reproducibility in children with and without unilateral cleft lip, alveolus and palate (UCLP) aged 3-18 months. Three to eight 3D facial images per time point were acquired within 10 min of 31 children with UCLP and 50 controls at 3, 12 and 18 months of age. 3D mapping of two 3D facial images per subject per age was performed. Distance kits of the full face and nasolabial area were calculated. In the total subject pool, mean variation between two 3D facial images ranged from 0.38-0.88 mm. There were no significant differences within groups for the various ages. Variation between controls and UCLP subjects did not differ significantly. Variation was higher in the nasolabial area than in the full face. The influence of involuntary facial expressions on the estimation of facial growth should not be underestimated, especially in the nasolabial region of UCLP subjects aged 3 months. To improve 3D ...
International Journal of Environmental Research and Public Health, 2021
This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very ...
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, 2015
Three-dimensional surface imaging is an increasingly popular modality for face measurements in infants with cleft lip and palate. Infants are noncompliant toward producing specific facial expressions, and selecting the appropriate moment of acquisition is challenging. The objective was to estimate amount and spatial distribution of deformation of the face due to facial expression in infants with cleft lip and palate and provide recommendations for an improved acquisition protocol, including a method of quality control in terms of obtaining images with true neutral expression. Three-dimensional surface images of ten 4-month-old infants with unrepaired cleft lip and palate were obtained using a 3dMDface stereophotogrammetric system. For each subject, five surface images judged as representing a neutral expression were obtained during the same photo session. Mean and maximum deformations were calculated. A formalized review was performed, allowing the image exhibiting the "bes...
Journal of Plastic, Reconstructive & Aesthetic Surgery
Background: Documenting cleft lip and palate morphology prior to surgery is standard care. Presurgical orthopedic treatment also requires a 3D cleft model. Endangering the airway, conventional impressions require additional safety measures and resources. We investigate the implementation and risks of digital impressions for the youngest patients with orofacial clefts. Methods: We report a retrospective cohort study of patients with cleft lip and palate, aged up to 6 years, treated at two cleft centers in Europe (Basel (A), Warsaw (B)). We scanned with the Medit i500 (Medit Corp, Seoul, South Korea). Center A for presurgical orthopedics and prior surgery from June 2020 to March 2022. Center B prior surgery from December 2020 to May 2021. Scanning data were analyzed for adverse events and adverse device effects, scanning duration, and number of images according to cleft type and age.
Comparison of Plaster Casting with Three-Dimensional Cranial Imaging
The Cleft Palate-Craniofacial Journal, 2005
Objective The development of a new cranial imaging system to capture a three-dimensional (3D) model of an infant's head has been previously reported. The accuracy of this new system has been independently established. However, before replacing the traditional plaster casting technique, the two methods require a comparison to ensure that the models they produce are equivalent. Methods Ten sequential infants were digitized by the 3D imaging system and the plaster casting technique following previously reported protocols. The cast models were also digitized so they could be compared with the digitized images. The two models (3dImage and Cast) were then imported into dimensional analysis software and aligned and registered with well-established registration algorithms. Difference maps that identified the variation between the two surfaces were generated for each pair, and descriptive statistics of these differences were recorded. Results The mean difference between the cast and the ...
3D Facial Analysis in Class II Subdivision Malocclusion
The Open Dentistry Journal
Background: Class II subdivision is an asymmetric condition presenting a Class I dental occlusion on one side and a Class II on the contralateral one. It presents a midline deviation that may be caused by a monolateral distalization of the mandible (type 1) or a mesialization of one side of the maxilla (type 2). The evaluation of asymmetry based on 2D radiographic records has been demonstrated to be less accurate than the one made using 3D radiographs. Objective: The aim of this work is to evaluate the facial asymmetry in a group of patients with Class II subdivision, compared to patients in Class I without evident asymmetry, by using 3D photographs of the face. Methods: 32 young adults with Class II subdivision were compared to a group of 32 subjects with bilateral Class I molar relationship. 3D photograph of their face was acquired using a stereophotogrammetric camera (3dMDtrio System-3dMD Atlanta, GA, USA). 3D photographs were imported into the Geomagic Software to create mirror ...
Related papers
Clinical oral investigations, 2018
To assess the influence of involuntary facial expressions on 3D facial stereophotogrammetry reproducibility in children with and without unilateral cleft lip, alveolus and palate (UCLP) aged 3-18 months. Three to eight 3D facial images per time point were acquired within 10 min of 31 children with UCLP and 50 controls at 3, 12 and 18 months of age. 3D mapping of two 3D facial images per subject per age was performed. Distance kits of the full face and nasolabial area were calculated. In the total subject pool, mean variation between two 3D facial images ranged from 0.38-0.88 mm. There were no significant differences within groups for the various ages. Variation between controls and UCLP subjects did not differ significantly. Variation was higher in the nasolabial area than in the full face. The influence of involuntary facial expressions on the estimation of facial growth should not be underestimated, especially in the nasolabial region of UCLP subjects aged 3 months. To improve 3D ...
Digital Surface Photogrammetry for Anthropometric Analysis of the Cleft Infant Face
The Cleft Palate-Craniofacial Journal, 2006
Objective To analyze the three-dimensional morphology of the cleft infant face with digital surface photogrammetry. Design Fifty plaster casts of unoperated infants with cleft lip and palate were imaged three-dimensionally with digital surface photogrammetry. Twenty-one standard craniofacial measurements were taken. The plaster casts were divided into 4 groups with unilateral, bilateral, complete, and incomplete clefts of the lip and palate. The measurements were compared with standard values for healthy infants. Results Significant differences (p < .0025) were found for the alar base width (33% to 55%), the alar base root width (59% to 103%), the width of the nose (7% to 25%), the length of the alar wing (18% to 25%), and the intercanthal (6% to 17%) and biocular (4% to 12%) width, depending on the cleft type. The vertical dimensions of the nose and the upper lip did not differ significantly from the controls. Conclusion This study describes preliminary data on the cleft infant ...
British Journal of Oral and Maxillofacial Surgery, 2014
The aims of this study were to assess the quantitative values of measurements using proportion indices in the craniofacial region in patients with repaired, non-syndromic, complete unilateral cleft lip and palate (UCLP), and compare them with a control group who did not have clefts using the non-invasive systems of 3-dimensional technology. Three-dimensional measurements of the facial surfaces of 15 Malay patients who had UCLP repaired and 100 Malay control patients aged 18-25 years were analysed. The 3-dimensional images of the respondents' faces were captured using the VECTRA-3D Stereophotogrammetry System. Eleven craniofacial proportions were assessed using a combination of 18 linear measurements obtained from 21 anthropometric soft tissue landmarks. These measurements were used to produce proportion indices to find the differences in the morphological features between the groups, and assessed using the independent sample t test and z scores. There were significant differences between the groups in 7 out of 11 craniofacial proportion indices (p = 0.001-0.044). Z scores of 2 indices were disproportionate. They were nasal index (which was severely supernormal) and upper lip index (which was moderately supernormal). Patients with UCLP had higher mean z scores, indicating that patients with UCLP tended to have larger faces than the control group. There were clinically important differences mainly in the nasolabial area, where the nose and the upper lip were wider, larger, or flatter in patients with UCLP.
The Cleft Palate-Craniofacial Journal
Objective: To validate a newly developed method for capturing 3-dimensional (3D) images of the nasolabial region for assessing upper lip scarring and asymmetry in surgically managed unilateral cleft lip and palate (UCLP) cases. Design: Validation study, single cohort. Materials and Methods: Eighteen surgically managed UCLP cases were recruited, the nasolabial region of each face was scanned using an intraoral scanner (IOS) to produce 3D images. The images were manually segmented to allow the calculation of surface area of the scar and upper lip asymmetry. Five professionals and 5 lay assessors subjectively evaluated the same images and graded the upper lip scarring and asymmetry at 2 separate occasions. The relationship between the subjective and objective assessments was evaluated. Results: Moderate correlation was found between subjective and objective evaluations of the upper lip scarring and total asymmetry. The captured 3D images were of good quality for the objective measureme...
Plastic and Aesthetic Research , 2020
Aim: The aims were: (1) to examine the clinical application of a geometric morphometric method (GMM) that quantifies the three-dimensional (3D) configuration of the facial soft tissues in patients with a repaired unilateral cleft lip and palate (UCLP); and (2) to determine the morphological characteristics that distinguish between non-cleft participants and patients with UCLP. Methods: 3D facial images at rest were recorded from Japanese patients with a repaired UCLP (Cleft group; n = 60) and healthy adults featuring a straight type facial profile with normal occlusion (Control group; n = 200) using 3D photogrammetric cameras. For each participant, wire mesh fitting was conducted based on the assignment of landmarks to each 3D facial image. This method generated landmark-based GMM models consisting of 6017 nodes on the fitted wire mesh. For each node, the mean and standard deviation were determined in the Control group and were used as the normative range of the faces. With this normative range, the Z-scores before and after surgery were evaluated for patients with UCLP who underwent orthognathic bimaxillary surgery. Further, the morphological characteristics of the Cleft group were evaluated using a principal component (PC) regression analysis that distinguished between two subject groups. In addition, K-means clustering analysis and MANOVA were used to examine the morphological variation of the Cleft group. Results: A patient with UCLP was evaluated with the system. After surgery, the normal area increased by 8%-20% on all axes, which means that the surgery was effective for normalizing the patient's face. However, even after
Objective Three-Dimensional Assessment of Lip Form in Patients with Repaired Cleft Lip
The Cleft Palate-Craniofacial Journal, 2010
Objectives To measure and compare three-dimensional lip form in participants with a repaired cleft lip and noncleft control participants. Design Retrospective study. Three-dimensional facial images of each participant were obtained. Participants The sample consisted of two groups: a repaired cleft lip group (n = 57) and a noncleft “normal” group (n = 28). Main Outcome Measures Thirty-four variables that described the features of each participant's lip form were extracted from the image data. A t test was used for each variable to test for significant differences between the groups, and a mathematical technique was used to categorize the lip forms in both groups. Results Seventeen variables showed significant between-group differences. The differences were focused on the free edges of the upper and lower lip vermilion borders, upper and lower lip protrusion, and lip symmetry. Lip forms were described by seven categories. Participants with cleft lip were represented in all categor...
The Cleft Palate-Craniofacial Journal, 2016
Objective To assess a three-dimensional (3D) stereophotogrammetric method for area delimitation and evaluation of the dental arches of children with unilateral cleft lip and palate (UCLP). Obtained data were also used to assess the 3D changes occurring in the maxillary arch with the use of orthopedic therapy prior to rhinocheiloplasty and before the first year of life. Design Within the collaboration between the Università degli Studi di Milano (Italy) and the University CES of Medellin (Colombia), 96 palatal cast models obtained from neonatal patients with UCLP were analyzed using a 3D stereophotogrammetric imaging system. Main Outcome Measures The area of the minor and greater cleft segments on the digital dental cast surface were delineated by the visualization tool of the stereophotogrammetric software and then examined. “Trueness” of the measurements, as well as systematic and random errors between operators' tracings (“precision”) were calculated. Results The method gave a...
3D comparison of average faces in subjects with oral clefts
SUMMARY This prospective cross-sectional, case-controlled morphometric study assessed three dimensional (3D) facial morphological differences between average faces of 103 children aged 8–12 years; 40 with unilateral cleft lip and palate (UCLP), 23 with unilateral cleft lip and alveolus (UCLA), 19 with bilateral cleft lip and palate (BCLP), 21 with isolated cleft palate (ICP), and 80 gender and age-matched controls. 3D stereophotogrammetric facial scans were recorded for each participant at rest. Thirty-nine landmarks were digitized for each scan, and x-, y-, z-coordinates for each landmark were extracted. A 3D photorealistic average face was constructed for each participating group and subjective and objective comparisons were carried out between each cleft and control average faces. Marked differences were observed between all groups. The most severely affected were groups where the lip and palate were affected and repaired (UCLP and UCLA). The group with midsagittal palatal deformity and repair (ICP) was the most similar to the control group. The results revealed that 3D shape analysis allows morphometric discrimination between subjects with craniofacial anomalies and the control group, and underlines the potential value of statistical shape analysis in assessing the outcomes of cleft lip and palate surgery, and orthodontic treatment
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