A novel accurate volumetric analysis protocol for evaluating secondary alveolar cleft reconstruction

An accurate volumetric analysis protocol for secondary alveolar cleft reconstruction is essential. It can help confirm favorable times for bone grafting, determine which graft material is more effective, and improve surgical techniques. This study aimed to introduce a novel protocol for precisely calculating the bone formation ratio (BF%) using computer-aided engineering. The helical computed tomography (CT) datasets of 14 patients who underwent alveolar cleft reconstruction was included in this study. CT scans performed preoperatively and 1 year postoperatively were evaluated by two investigators. Digital Imaging and Communications in Medicine (DICOM) data were reconstructed as three-dimensional (3D) images using Mimics software and processed by Geomagic Wrap (2017). Using the Boolean operation, the newly formed bone of the alveolar cleft was segmented by identifying the differences between pre- and postoperative 3D images. The volumetric assessment and morphological analysis of the newly formed bone could be determined in a precise manner, the mean BF% was 47.7% ± 16.4%, the mean time required for calculating was 23.57 ± 3.64 min. For the difference in the volume of newly formed bone between the two observers, the intraclass correlation coefficient (ICC) was 0.92, p < 0.001. This method is clinically practical and precise measurement, which has good reproducibility for evaluating outcome of different grafting materials for alveolar clefts.