Enhanced clinical assessment of orofacial clefts using interactive 3D visualization from cinematic rendering

Patients with orofacial clefts (OFCs) present with a complex bony and dental anatomy that often necessitates the use of cross-sectional imaging for orthodontic treatment and subsequent surgical cleft repair. Cinematic rendering (CR) is a recently developed photorealistic display technique that employs physically-based photorealistic volume rendering to create 3D images from DICOM data. The objective of this technical report was to develop and optimize previously established CR settings for midface and dental anatomy to align with the specific requirements of 3D visualization in OFCs. CR was applied for volumetric image visualization for DICOM datasets of 3 different types of OFCs, including right-sided cleft of the lip, alveolus, and palate (CLP), left-sided CLP and bilateral CLP. CT examination settings were individual for each patient case. In order to present the dental and bony anatomy of the upper and lower jaw in an optimal fashion, previously established custom-made rendering presets were refined for this specific issue. This technical report is the first to use CR for the visualization of the hard palate, the cleft area, and adjacent dentition in patients with OFCs. In order to achieve the most natural image impression in the context of CR, the soft kernel was employed. If the clinical context necessitates a more detailed image impression, rendering of datasets with slightly elevated doses and thinner slice thickness is recommended.