New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal

Area of Science:

• Craniofacial surgery
• Medical imaging
• Dental and oral surgery

Background:

• Existing classifications for developmental defects lack preoperative radiographic evaluation integration.
• Computed tomography (CT) scans offer detailed preoperative assessment for cleft lip and palate management.
• Diverse treatments exist, but a standardized classification based on imaging is needed.

Purpose of the Study:

• To propose a novel classification system for alveolar clefts based on CT scan analysis.
• To enhance surgical planning and treatment strategies for cleft alveolus.
• To establish a clinically relevant, CT-based system for the digital era.

Main Methods:

• Retrospective evaluation of archived CT scans for alveolar cleft morphology.
• Comprehensive literature search (MEDLINE) for existing cleft classification systems.
• Development of a new classification based on CT-observed morphological patterns and extent of cleft.

Main Results:

• Identified five distinct types of alveolar clefts based on CT scan extent.
• Found no prior classification exclusively using CT scans for cleft alveolus.
• Reviewed twenty-nine historical classifications from 1922 to 2015.

Conclusions:

• A CT scan-based classification is crucial for successful alveolar cleft surgical planning.
• The proposed system offers clinical relevance and aids in relating surgical outcomes in the digital age.
• Three-dimensional CT imaging facilitates virtual planning and improves patient satisfaction.