Three-Dimensional High-Resolution Mesh Analysis of Mixed-Dentition Intraoral Models for Predicting Future Orthognathic Surgery in Patients With Cleft Lip and/or Palate

Vollständiger Abstract

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Objective To evaluate the 3-dimensional (3D) geometric characteristics of mixed-dentition intraoral models and identify morphological features associated with later inclusion of orthognathic surgery (OGS), rather than camouflage treatment alone (non-OGS/NOGS), as a treatment option in patients with cleft lip and/or palate (CL/P). Design Retrospective cohort study. Setting Institutional study. Participants A total of 320 patients with unilateral or bilateral CL/P who received first-phase orthodontic treatment at ages 5 to 7 years (T1) and continued treatment until age 15 (T2). Main Outcome Measures Intraoral models obtained at T1 were digitized with a 3D scanner. Dentition and palatal morphology were quantified using a high-resolution template-based geometric morphometric method based on dense corresponding surface vertices and summarized as principal components (PCs). Logistic regression models incorporating PCs and clinical variables (number of alveolar clefts, palatal repair method, sex, and number of missing teeth) were used to predict whether OGS was included as a treatment option at T2. Surface-based group differences were assessed using 2-sample t -tests ( P < .05). Results Significant morphological differences between OGS and NOGS groups were identified in both maxillary and mandibular dental arches at T1. Features associated with OGS inclusion were a narrow maxillary arch, a shallow palate, Class III dentoalveolar relationships, a steep occlusal plane, and lingual tooth displacement. The predictive model demonstrated good discriminative performance, with an area under the receiver operating characteristic curve of 0.82. Conclusions 3D mixed-dentition intraoral models at T1 captured dentition and palate features predictive of later consideration of OGS during treatment planning in patients with CL/P.