Photon-counting CT and 0.55 T MRI-a novel diagnostic imaging method for evaluating orofacial clefts: a case report

Orofacial clefts (OFCs) are the most common type of craniofacial anomaly, with a global incidence ranging from 1 in 500 to 1 in 2,500 live births. Dental rehabilitation for patients with OFCs involves considerations that extend beyond mere cosmetic concerns. During their orthodontic treatment, pediatric patients with OFCs are exposed to ionizing radiation from both two-dimensional (2D) and three-dimensional (3D) radiography, significantly increasing their lifetime radiation dose compared with children without OFCs. This report presents the case of a 15-year-old boy with a complete left-sided cleft lip, alveolus, and palate who required orthodontic treatment. 2D imaging during routine orthodontic diagnostics revealed unclear findings in the apical region of teeth 13 and 27. Given the need to assess these findings as well as the cleft region three-dimensionally prior to tooth movement of cleft adjacent teeth, 3D imaging was deemed necessary. This case report presents a novel, multimodal diagnostic approach to 3D imaging, encompassing photon-counting computed tomography and low-field 0.55 T magnetic resonance imaging, tailored to the specific needs of pediatric patients with OFCs.