A software tool used in 3D evaluation of the alveolar bone defect in bilateral cleft lip and palate patients

Evaluation of the cleft size and the assessment of an estimative volume required for bone grafting provide useful information to the surgeon performing secondary alveolar bone grafting. To use a software tool to evaluate the estimative volume of the bone defect in the alveolar cleft area, based on cone beam computed tomography (CBCT) data. Three patients with bilateral cleft lip and palate (BCLP) were randomly selected in the order of referral to treatment at "Saint Mary" Emergency Hospital for Children. CBCT examinations were performed prior to secondary alveolar bone grafting procedure. The preoperative estimative volume (PEV) of the alveolar bone defect was evaluated by three observers with different areas of expertise (a dentomaxillofacial radiologist, a maxillofacial surgeon, and a Ph.D. radiology student), using Romexis 3.0.1 software program. The inter-observer fidelity was assessed using the Interclass Correlation Coefficient (ICC), with an optimal value of 0.837 for all observers. The mean PEV for all BCLP patients was 1.84 +/- 0.16 cm3. The results suggest that measuring the preoperative estimative volume of the alveolar bone defect in CLP patients using Romexis 3.0.1 software program, with CBCT scan data is beneficial. A proper protocol should be established, in order to provide useful information for the surgeon performing the secondary alveolar bone grafting.