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Measuring Progressive Soft Tissue Change With Nasoalveolar Molding Using a Three-dimensional System

Simanca, Erika DDS*; Morris, David MD†‡; Zhao, Linping PhD‡§; Reisberg, David DDS; Viana, Grace MSc

doi: 10.1097/SCS.0b013e31822e8ca0
Original Articles

Background: For craniofacial orthodontics and surgery to progress, accurate temporal evaluation of soft tissue and skeletal change with treatment is necessary. Evolution in three-dimensional imaging eliminates certain inherent challenges in making such measurements in infants with facial clefts.

Objective: The aim of this pilot study was to measure progressive three-dimensional changes in nasal form in a series of infants with facial clefts during the course of presurgical nasoalveolar molding.

Materials and Methods: In 5 infants with unrepaired cleft lip and palate, three-dimensional photographs were obtained using the 3dMD system (3dMD, Inc, Atlanta, GA) at 2-week intervals during nasoalveolar molding treatment. Using the 3dMD Vultus software, temporal soft tissue changes were evaluated quantitatively based on three-dimensional linear measurements of 3 landmarks in the nasal area and qualitative changes in the surface shell.

Results: Increase in columellar length on the cleft side and decrease of the nostril floor on the noncleft side were observed in all subjects. Progressive changes were observed most significantly in week 4 (T3) into treatment.

Conclusions: This pilot study describes an approach using the 3dMD photo system with Vultus software for measuring the progressive change in the nasal soft tissues. The 3dMD system was believed to be valuable for facial analysis in this setting.

From the *Division of Plastic Surgery, The Craniofacial Center - Craniofacial Orthodontics and †Plastic and Craniomaxillofacial Surgery, The Craniofacial Center, University of Illinois at Chicago; ‡Shriners Hospital for Children, Oak Park; and §Division of Plastic Surgery, The Craniofacial Center, ∥Division of Plastic Surgery, The Craniofacial Center - Maxillofacial Prosthetics, and ¶Department of Orthodontics, Statistics, University of Illinois at Chicago, Illinois.

Received May 4, 2011.

Accepted for publication July 12, 2011.

Address correspondence and reprint requests to Erika Simanca, DDS, The Craniofacial Center (MC 588), 811 S Paulina St, Chicago, IL 60612; E-mail:

This article was presented at the Midwestern Association of Plastic Surgeons, 49th Annual Meeting, May 2010, Chicago, IL.

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD