Comparative Volume Analysis of Alveolar Defects by 3D Simulation

Area of Science:

• Oral and Maxillofacial Surgery
• Craniofacial Anomalies
• Medical Imaging Technology

Background:

• Precise volumetric assessment of maxillary alveolar defects is crucial for cleft lip and palate (CLP) patients.
• Current methods lack standardized volumetric assessment techniques, impacting surgical planning and outcomes.
• Accurate defect volume measurement aids in reducing donor site morbidity and preparing bone substitutes.

Purpose of the Study:

• To compare the accuracy and reliability of two cone-beam computed tomography (CBCT)-based surgical simulation methods for volumetric assessment of alveolar cleft defects.
• To evaluate the equivalence of 3D real-scale printed models versus virtual surgical methods in measuring alveolar defect volumes.
• To establish reliable defect-specific volumes for improved alveolar bone graft surgery planning.

Main Methods:

• Presurgical CBCT scans from 32 patients with unilateral or bilateral clefts were analyzed.
• Two hands-on CBCT-based volumetric measurement methods were compared: 3D real-scale printed models and virtual surgical simulation.
• Intra- and inter-examiner reliability was assessed using intraclass correlation coefficients (ICC).

Main Results:

• Both 3D printing-based and virtual surgical methods yielded equivalent volumetric measurements for unilateral (1.09 mL) and bilateral (2.05 mL vs 2.02 mL) alveolar cleft defects.
• Bland-Altman analysis confirmed the equivalence of the two methods for defect assessment.
• No significant differences were found between different CBCT densities for model production and volume measurement.

Conclusions:

• 3D-printed models and virtual surgical simulations provide equally quantifiable and reliable volumetric assessments of alveolar cleft defects.
• These CBCT-based methods offer valuable, defect-specific volume data for planning and executing alveolar bone graft surgeries.
• The findings support the adoption of either 3D-printed or virtual methods for precise volumetric assessment in CLP patients.