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Does the Central Nasolabial Aesthetic Subunit Improve after Secondary Alveolar Bone Grafting? A Three-Dimensional Morphometric Study
Vikas S. Kotha MD; Konstantinos Apostolopoulos, DDS, MSD; Rany M. Bous DMD; Edward H. Davidson, MA(Cantab), MBBS; Manish Valiathan DDS; Anand R. Kumar MD
Case Western Reserve University
2021-02-15
Presenter: Vikas S. Kotha MD
Affidavit:
100% of this project represents original work of the resident
Director Name: Edward Davidson
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: Secondary alveolar bone grafting (SABG) affects the central nasolabial aesthetic subunit in unilateral complete cleft lip. Soft tissue changes after bone grafting in the overlying central face remains under characterized. We hypothesized that soft tissue changes after bone grafting would induce favorable volumetric and linear changes in the study area.
Methods: An IRB-approved retrospective case study (2019-2020) was performed evaluating 3D stereophotogrammetry images (Canfield Vectra). Primary predictor variables were Enmark status and time between images. Primary outcome variables were soft tissue volume (STV), columellar length (CL), alar width (AW), and nasolabial angle (NLA). Standard statistical analysis was performed using SPSS 27.
Results: Six patients met inclusion criteria; mean age at SABG n=10.4 years, mean imaging time N=111 days All SABGs procedures were Enmark 3 or greater. Upper lip volume (ULV) (cc) increased from 112 vs.122, NL angle 114º vs. 129º, whereas AL decreased from 9.3 mm vs 8.7 mm and AW from 9.6 mm vs 9.3 mm (p=.008, .018, .004, .007 respectively). When comparing the affected to non-affected side to control for growth, ULV increased 0.89 cc vs. 0.53 cc, NL angle 10.7º vs. 8.1º and AL decreased from -0.62 mm vs -0.06, AW -0.35 mm vs. +0.87 (p=.018, .008, .004, .008 respectively)
Conclusion: The central nasolabial aesthetic subunit is favorably affected by expansion of the upper lip volume and nasolabial angle whereas alar length and alar width are significantly decreased after SABG. Our findings demonstrate reliable volumetric expansion of the lip at the cost of worsening alar shape.
