Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data
Aim To compare three-dimensional (3D) facial morphology of various unilateral cleft subphenotypes at 9-years of age to normative data using a general face template and automatic landmarking. The secondary objective is to compare facial morphology of 9-year-old children with unilateral fusion to diff...
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2025-01-01
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| author | Marjolein Crins-de Koning Robin Bruggink Marloes Nienhuijs Till Wagner Ewald M. Bronkhorst Edwin M. Ongkosuwito |
| author_facet | Marjolein Crins-de Koning Robin Bruggink Marloes Nienhuijs Till Wagner Ewald M. Bronkhorst Edwin M. Ongkosuwito |
| author_sort | Marjolein Crins-de Koning |
| collection | DOAJ |
| description | Aim To compare three-dimensional (3D) facial morphology of various unilateral cleft subphenotypes at 9-years of age to normative data using a general face template and automatic landmarking. The secondary objective is to compare facial morphology of 9-year-old children with unilateral fusion to differentiation defects. Methods 3D facial stereophotogrammetric images of 9-year-old unilateral cleft patients were imported into 3DMedX® for processing. All images of patients with a right sided cleft were mirrored. A regionalized general facial template was used for standardization. This template was pre-aligned to each face using five automatically determined landmarks and fitted using MeshMonk. All cleft patients were compared to an age-and gender matched normative face using distance maps and inter-surface distances (mm). Average faces were created for five groups (unilateral cleft lip, alveolus, and/or palate (UCL/A/P), fusion and differentiation defects). The selected regions for the evaluation of facial morphology were: complete face, nose, upper lip, lower lip, chin, forehead, and cheeks. Results A total of 86 consecutive 3D-stereophotogrammetry images were acquired for examination. No statistically significant differences were observed among the UCL, UCLA, and UCLP groups for the complete face, cheeks, chin, forehead, lower lip, and nose. However, in the upper lip region a significant difference was observed between the UCLP and UCL groups (P = 0.004, CI [−2.93 to −0.48]). Further visual examination of the distance maps indicated that more severe clefts corresponded to increased retrusion in the midface and the tip of the nose, though these differences were not statistically significant across groups. For fusion vs differentiation defects, no statistically significant differences were observed, neither for the complete face nor for any of the individual regions. Conclusion The findings demonstrate statistically significant differences in the upper lip region between children with UCL and those with UCLP, particularly with greater upper lip retrusion in the UCLP group. The use of color-coded distance maps revealed local variations and a trend of asymmetry in the nasal region, with increasing retrusion of the nose tip, upper lip, and cheeks correlating with the severity of the cleft. Although these trends were not statistically significant, they suggest a progressive facial retrusion pattern as cleft severity increases. For the secondary objective, no statistical differences were found between the facial morphology of children with fusion and differentiation defects, although a similar progression of maxillary retrusion was observed in the distance maps. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-0c3eaed256c44c9aae4437ef09dbd8542025-01-23T15:05:12ZengPeerJ Inc.PeerJ2167-83592025-01-0113e1873910.7717/peerj.18739Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative dataMarjolein Crins-de Koning0Robin Bruggink1Marloes Nienhuijs2Till Wagner3Ewald M. Bronkhorst4Edwin M. Ongkosuwito5Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Medical Center, Nijmegen, NetherlandsSection of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, NetherlandsAmalia Cleft and Craniofacial Center, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Dentistry, Radboud University Medical Center, Nijmegen, NetherlandsSection of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Medical Center, Nijmegen, NetherlandsAim To compare three-dimensional (3D) facial morphology of various unilateral cleft subphenotypes at 9-years of age to normative data using a general face template and automatic landmarking. The secondary objective is to compare facial morphology of 9-year-old children with unilateral fusion to differentiation defects. Methods 3D facial stereophotogrammetric images of 9-year-old unilateral cleft patients were imported into 3DMedX® for processing. All images of patients with a right sided cleft were mirrored. A regionalized general facial template was used for standardization. This template was pre-aligned to each face using five automatically determined landmarks and fitted using MeshMonk. All cleft patients were compared to an age-and gender matched normative face using distance maps and inter-surface distances (mm). Average faces were created for five groups (unilateral cleft lip, alveolus, and/or palate (UCL/A/P), fusion and differentiation defects). The selected regions for the evaluation of facial morphology were: complete face, nose, upper lip, lower lip, chin, forehead, and cheeks. Results A total of 86 consecutive 3D-stereophotogrammetry images were acquired for examination. No statistically significant differences were observed among the UCL, UCLA, and UCLP groups for the complete face, cheeks, chin, forehead, lower lip, and nose. However, in the upper lip region a significant difference was observed between the UCLP and UCL groups (P = 0.004, CI [−2.93 to −0.48]). Further visual examination of the distance maps indicated that more severe clefts corresponded to increased retrusion in the midface and the tip of the nose, though these differences were not statistically significant across groups. For fusion vs differentiation defects, no statistically significant differences were observed, neither for the complete face nor for any of the individual regions. Conclusion The findings demonstrate statistically significant differences in the upper lip region between children with UCL and those with UCLP, particularly with greater upper lip retrusion in the UCLP group. The use of color-coded distance maps revealed local variations and a trend of asymmetry in the nasal region, with increasing retrusion of the nose tip, upper lip, and cheeks correlating with the severity of the cleft. Although these trends were not statistically significant, they suggest a progressive facial retrusion pattern as cleft severity increases. For the secondary objective, no statistical differences were found between the facial morphology of children with fusion and differentiation defects, although a similar progression of maxillary retrusion was observed in the distance maps.https://peerj.com/articles/18739.pdfThree-dimensionalMaxillofacial developmentOrthodonticsStereophotogrammetryDiagnostic imagingImaging |
| spellingShingle | Marjolein Crins-de Koning Robin Bruggink Marloes Nienhuijs Till Wagner Ewald M. Bronkhorst Edwin M. Ongkosuwito Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data PeerJ Three-dimensional Maxillofacial development Orthodontics Stereophotogrammetry Diagnostic imaging Imaging |
| title | Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data |
| title_full | Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data |
| title_fullStr | Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data |
| title_full_unstemmed | Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data |
| title_short | Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data |
| title_sort | three dimensional analysis of facial morphology in nine year old children with different unilateral orofacial clefts compared to normative data |
| topic | Three-dimensional Maxillofacial development Orthodontics Stereophotogrammetry Diagnostic imaging Imaging |
| url | https://peerj.com/articles/18739.pdf |
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