12/31/2023 0 Comments Inmr from scanThe Malaysian patient database established at the Australian Craniofacial Unit (ACFU), Adelaide Women’s and Children’s Hospital, provided the 3D CT scans of the subjects. A midline plane constructed from the landmarks basion (ba), sella (s), and nasion (n) was used to assess asymmetry in the selected craniofacial variables in both the CLP and the NC groups. Differences in morphologies of the nasal bones were emphasised. The overall aim of this study was to compare the craniofacial morphologies in a sample of unoperated Malaysian infants with CLP with those in a sample of age-matched, unaffected, non-cleft (NC) Malaysian infants. Consequently, 3D CT scanning was deemed most suitable for data collection in our study. Data obtained with 3D CT scanning can be used for soft and hard tissues analysis, whereas methods based on laser techniques are used mainly for the analysis of soft tissue surfaces. Other available 3D imaging techniques include morphoanalysis, laser scanning, stereolithography, 3D ultrasonography, 3D facial morphometry, digigraph imaging, Moiré topography, and contour photography ( 1). Hence, three dimensional (3D) imaging techniques have been developed to overcome the shortcomings of conventional 2D methods and were applied in the present study specifically, 3D computed tomography (CT) was used. However, there are limitations in the measurement of asymmetry using two-dimensional (2D) radiographs, such as the super-imposition of structures and the reliance on machine positioning relative to the external auditory meati, which can be asymmetric within individuals ( 14). Methodologically, cephalometric and panoramic radiographs have traditionally served as the primary option for the radiographic analysis of craniofacial morphology. Therefore, the present study included an assessment of asymmetry by comparing landmark measurements from the left and right sides of the face. The assessment of facial asymmetry is an important component of evaluating the success of surgical repair in CLP and is linked to psychological issues such as perceptions of attractiveness and intelligence ( 13). Fluctuating asymmetry refers to small, random differences in size between sides of the body, for example the face, and is thought to reflect developmental instability, whereas directional asymmetry involves a consistent trend in which one side is larger or smaller than the other and may be influenced by homeobox genes ( 10– 12). Regardless of the pathogenesis or genetics, anomalous developmental conditions, such as cleft lip and palate (CLP), are often associated with increased levels of asymmetry, which have been described as fluctuating or directional asymmetry ( 10). Changes in facial growth and development in cleft children likely reflect the combined effect of genes and the environment that is, clefts result from multifactorial influences that affect the growth potential of the face and the overall symmetry of the soft tissues and facial bones ( 5). Conversely, other researchers have found little evidence supporting these findings ( 9). Specifically, the MSX1 gene has been associated with cleft palate, and the MSX1 and TGFβ3 genes have been associated with cleft lip, with or without cleft palate ( 7, 8). Although functional or iatrogenic factors are generally thought to affect normal facial morphology and growth potential ( 5, 6), it is understood that there is an underlying genetic basis for the formation of clefts ( 7). live births ( 3) and 1 in every 500 to 550 live births, with the highest rates observed among the Asians ( 4). It demonstrates a prevalence that ranges from 0.04 to 0. Nonsyndromic cleft lip, with or without cleft palate, is relatively common. Patients with orofacial clefts present with a variety of problems including dental anomalies, malocclusions, disorders of speech and hearing, and secondary facial deformities ( 1, 2).
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