Sennimalai Karthik, Selvaraj Madhanraj, Siddiqui Hamza Parvez, Monga Nitika, Sameemullah Kathijathul Hidhaya
Assistant Professor, Department of Orthodontics, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu and Kashmir, India.
Senior Resident, Division of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
J World Fed Orthod. 2024 Dec;13(6):265-278. doi: 10.1016/j.ejwf.2024.06.001. Epub 2024 Jul 29.
In the realm of cleft lip and palate (CLP) care, the integration of intraoral scanners (IOS) may offer a promising avenue, enabling precise digital imaging, record-keeping, treatment planning and execution. This scoping review aimed to explore the current applications of IOS in CLP patients and discuss potential future directions for optimizing the utilization of IOS in cleft care.
The review was registered apriori in the Open Science Framework (OSF) Registries (https://doi.org/10.17605/OSF.IO/KPD34). A systematic search was conducted across various databases like Ovid MEDLINE, PubMed, Cochrane Library, Embase, Web of Science, Scopus, Google Scholar, Grey literature, and Trial registries using a broad search strategy. The articles published in any language till December 20, 2023 were considered. Studies that demonstrated the application of intraoral scanning in nonsyndromic CLP patients were included. A validated sixteen-item content assessment tool was used to evaluate the included studies. Two independent reviewers performed data extraction and content assessment.
Fifteen research studies and thirteen case reports/series were included in the final analysis. Various applications included capturing intraoral and extraoral images, scanning orthodontic study models, assessing dental changes, monitoring treatment changes related to nasoalveolar molding therapy, and fabricating appliances. The content assessment showed below-average mean scores of 34.79 ± 9.37% for research studies and 39.7 ± 0.14% for case reports/series. This can be attributed to insufficient information on scanning parameters, methodology, accuracy, patient outcomes, limitations, and potential solutions. The reproducibility of landmark identification in IOS was within 0.2 mm. Patients and caregivers preferred digital impressions over traditional alginate methods, reporting positive experiences in 84.8% of cases.
Intraoral scanners offer good clinical accuracy and validity in assessing dentofacial and nasolabial morphology in cleft patients. Adopting IOS can streamline clinical workflows, enhance treatment accuracy, and improve patient outcomes in managing cleft lip and palate.
在唇腭裂（CLP）治疗领域，口腔内扫描仪（IOS）的整合可能提供一条有前景的途径，实现精确的数字成像、记录保存、治疗计划制定与执行。本综述旨在探讨IOS在CLP患者中的当前应用，并讨论在腭裂治疗中优化IOS使用的潜在未来方向。
该综述预先在开放科学框架（OSF）注册库（https://doi.org/10.17605/OSF.IO/KPD34）中注册。使用广泛的搜索策略，在多个数据库中进行系统搜索，如Ovid MEDLINE、PubMed、Cochrane图书馆、Embase、科学网、Scopus、谷歌学术、灰色文献和试验注册库。纳入截至2023年12月20日以任何语言发表的文章。纳入展示口腔内扫描在非综合征性CLP患者中应用的研究。使用经过验证的16项内容评估工具来评估纳入的研究。两名独立评审员进行数据提取和内容评估。
最终分析纳入了15项研究和13例病例报告/系列。各种应用包括获取口腔内和口腔外图像、扫描正畸研究模型、评估牙齿变化、监测与鼻牙槽塑形治疗相关的治疗变化以及制作矫治器。内容评估显示，研究的平均得分低于平均水平，为34.79±9.37%，病例报告/系列为39.7±0.14%。这可归因于扫描参数、方法、准确性、患者结局、局限性和潜在解决方案方面的信息不足。IOS中地标识别的可重复性在0.2毫米以内。患者和护理人员更喜欢数字印模而非传统藻酸盐方法，84.8%的病例报告了积极体验。
口腔内扫描仪在评估腭裂患者的牙颌面和鼻唇形态方面具有良好的临床准确性和有效性。采用IOS可以简化临床工作流程，提高治疗准确性，并改善唇腭裂管理中的患者结局。
