Department of Oral and Maxillofacial Surgery, and Dentistry, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India.
Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India, Phone: +91 9912400988,
J Contemp Dent Pract. 2020 Aug 1;21(8):942-948.
The present study proposed a new classification system based on computed tomography (CT) scan appraisal; this enables the surgeon to identify the extent of the defect and helps to execute the proper treatment plan.
Various terminologies and classifications were proposed to understand developmental defects. But none of the existing classifications/nomenclatures used the preoperative radiographic evaluation (i.e., computed tomography scan-CT scan) in the management and prognosis. Various treatments were advocated and practiced successfully for the surgical correction of lip and palate.
The available CT scans from archives of the Department of Radiology and Oral and Dental Surgery were evaluated (retrospectively) for cleft alveolus and its morphology as per the proposal. The English language literature was searched in the MEDLINE database without date restriction to revise existing literature on numerous classification systems/nomenclatures using MeSH keywords related to cleft lip, palate, alveolus, developmental disturbance, facial clefts, and classification. Existing classification systems were revisited with a note on the drawbacks. After careful examination of morphological patterns of all clefts, the new CT scan-based alveolar cleft classification is proposed depending on the extent of cleft.
The literature revealed a total of twenty-nine classifications of cleft lip and palate starting from the year 1922 to the year 2015, but none exclusively classified the cleft alveolus based on CT scan observations. The observation of three thousand CT scans showed five types of cleft alveolus, depending on the extent of involvement.
The CT scan-based classification is essential to the surgeon for successful surgical planning of cleft alveolus. The proposed classification is clinically relevant in this digital era for relating surgical outcomes. The three-dimensional viewing of a defect is essential for the surgeon for virtual planning. This paper provides a CT scan-based classification for universal acceptance in this era of digital technology, and CT scan aids in achieving these goals.
The new proposal is based on preoperative evaluation of cleft using a CT scan. CT scan imaging provides a clear picture of the cleft in three dimensions for the operating surgeon. Advanced technology-enhanced surgical management modalities like CAD/CAM guided templates to support graft for successful management. The classification system will help the medical and surgical fraternity in various aspects. The three-dimensional modeling of defect and printing of a defect model using additive manufacturing technology helps the surgeon for presurgical visualization and virtual planning in a better way. This strategy of defect classification using a CT scan will help obtain better clinical outcomes and patient satisfaction.
本研究提出了一种基于计算机断层扫描（CT 扫描）评估的新分类系统；这使外科医生能够识别缺陷的程度，并有助于执行适当的治疗计划。
已经提出了各种术语和分类来理解发育缺陷。但现有的分类/命名法都没有在管理和预后中使用术前影像学评估（即计算机断层扫描）。各种治疗方法被提倡并成功应用于唇腭裂的手术矫正。
评估（回顾性）来自放射科和口腔颌面外科档案的可用 CT 扫描，以根据建议评估牙槽裂及其形态。在 MEDLINE 数据库中搜索英语文献，无日期限制，使用与唇裂、腭裂、牙槽裂、发育障碍、面裂和分类相关的 MeSH 关键词修订关于众多分类系统/命名法的现有文献。重新审视现有的分类系统，并注意其缺点。在仔细检查所有裂隙的形态模式后，根据裂隙的程度提出了一种新的基于 CT 扫描的牙槽裂分类。
文献显示，从 1922 年到 2015 年，总共提出了 29 种唇腭裂分类，但没有一种是专门根据 CT 扫描观察结果对牙槽裂进行分类的。对 3000 例 CT 扫描的观察显示，根据受累程度，牙槽裂有五种类型。
CT 扫描分类对外科医生成功进行牙槽裂手术计划至关重要。在数字时代，该分类与临床相关，可用于评估手术结果。外科医生需要对缺陷进行三维观察，以便进行虚拟规划。本文提供了一种在数字技术时代通用的基于 CT 扫描的分类方法，CT 扫描有助于实现这些目标。
新的建议是基于术前使用 CT 扫描评估裂隙。CT 扫描成像为手术外科医生提供了三维裂隙清晰图像。先进的技术增强型手术管理方式，如 CAD/CAM 引导模板，用于支持移植物以实现成功管理。该分类系统将在各个方面帮助医疗和外科专业人员。使用增材制造技术对缺陷进行三维建模和打印缺陷模型有助于外科医生更好地进行术前可视化和虚拟规划。使用 CT 扫描对缺陷进行分类的这种策略将有助于获得更好的临床结果和患者满意度。
