Palatal symmetry analysis of surgical protocols for oral clefts by 3D stereophotogrammetry

Abstract

This study aimed to compare the dimensional alterations of the dental arches and the palate symmetry in patients with unilateral complete cleft lip and palate before and after the performance of primary surgeries by different surgical techniques. The sample was divided into Group 1, G1 - cheiloplasty (Millard technique) and single-stage palatoplasty (von Langenbeck technique); Group 2, G2 - cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler and Sommerlad techniques). The digital dental models were evaluated before (Time 1, T1) and after (Time 2, T2) primary surgeries. The straight linear (I-C, I-T, C-T, I-C', I-T', C'-T') and angular measurements (< ICT, < CTT', < IC'T', < C'T'T) were performed. Statistical analysis was applied with α = 5%. In the intragroup analysis, G1 and G2 showed a significant increase in T2 for all linear parameters except I-C' and I-T' and a decrease in all angular parameters except for < IC'T' in G1 and < CTT' in G2. In the intergroup analysis, at T2, there was an increase in C-T and I-T' and a decrease in < ICT for G2. Regarding the asymmetry in T1, for G1 and G2, we observed asymmetry in I-C vs I-C', I-T vs I-T', C-T vs C'-T', and < CTT' vs < C'T'T analyses. At T2, we observed asymmetry in all parameters except for I-T vs I-T' in G1 and for C-T vs C'-T' in G2. It is concluded that in following single-stage palatoplasty, there is symmetry in the total segment length, while two-stage palatoplasty is specifically effective in preserving symmetry in the posterior segment length.

Keywords: Cleft lip; Cleft palate; Dental arch; Imaging; Maxillofacial development; Three-dimensional.