PDF(Pubmed)
Abstract：
OBJECTIVE: Unilateral complete cleft lip and palate (UCCLP) is one of the most severe clinical subtypes among cleft lip and palate (CLP), making repair surgery and subsequent orthodontic treatment particularly challenging. Presurgical nasoalveolar molding (PNAM) has shown conflicting and heterogeneous results in the treatment of UCCLP patients, raising questions about whether the diversity in alveolar anatomical morphology among these patients plays a role in the effectiveness of PNAM treatment.
METHODS: We collected 90 digital maxillary models of infants with UCCLP and performed mathematical clustering analysis, including principal component analysis (PCA), decision tree modeling, and area under the ROC Curve (AUC) analysis, to classify alveolar morphology and identify key measurements. We also conducted clinical evaluations to assess the association between the alveolar morphology and CLP treatment outcomes.
RESULTS: Using mathematical clustering analysis, we classified the alveolar morphology into three distinct types: average form, horizontal form, and longitudinal form. The decision tree model, AUC analysis, and comparison analysis revealed that four measurements (Trans ACG-ACL, ML length, MG length and Inc length) were essential for clustering the alveolar morphology of infants with UCCLP. Furthermore, the blinded clinical evaluation indicated that UCCLP patients with alveolar segments of horizontal form had the lowest treatment outcomes.
CONCLUSIONS: Overall, our findings establish a novel quantitative classification system for the morphology of alveolar bone in infants with UCCLP and suggest that this classification may be associated with the outcomes of CLP treatment.
CONCLUSIONS: The multidisciplinary CLP team should thoroughly evaluate and classify the specific alveolar morphology when administering PNAM to infants with UCCLP.
METHODS: We collected 90 digital maxillary models of infants with UCCLP and performed mathematical clustering analysis, including principal component analysis (PCA), decision tree modeling, and area under the ROC Curve (AUC) analysis, to classify alveolar morphology and identify key measurements. We also conducted clinical evaluations to assess the association between the alveolar morphology and CLP treatment outcomes.
RESULTS: Using mathematical clustering analysis, we classified the alveolar morphology into three distinct types: average form, horizontal form, and longitudinal form. The decision tree model, AUC analysis, and comparison analysis revealed that four measurements (Trans ACG-ACL, ML length, MG length and Inc length) were essential for clustering the alveolar morphology of infants with UCCLP. Furthermore, the blinded clinical evaluation indicated that UCCLP patients with alveolar segments of horizontal form had the lowest treatment outcomes.
CONCLUSIONS: Overall, our findings establish a novel quantitative classification system for the morphology of alveolar bone in infants with UCCLP and suggest that this classification may be associated with the outcomes of CLP treatment.
CONCLUSIONS: The multidisciplinary CLP team should thoroughly evaluate and classify the specific alveolar morphology when administering PNAM to infants with UCCLP.
摘要：
目的：单侧完全性唇腭裂（UCCLP）是唇腭裂（CLP）中最严重的临床亚型之一，使修复手术和随后的正畸治疗特别具有挑战性。术前鼻肺泡成型（PNAM）在UCCLP患者的治疗中显示出相互矛盾和异质的结果，这些患者的肺泡解剖形态的多样性是否在PNAM治疗的有效性中起作用。
方法：我们收集了90个UCCLP婴儿的数字上颌模型，并进行了数学聚类分析，包括主成分分析(PCA)，决策树建模，和ROC曲线下面积（AUC）分析，对肺泡形态进行分类并确定关键测量值。我们还进行了临床评估，以评估肺泡形态与CLP治疗结果之间的关系。
结果：使用数学聚类分析，我们将肺泡形态分为三种不同的类型：平均形态，水平形式,和纵向形式。决策树模型,AUC分析,和比较分析表明，四个测量(TransACG-ACL，ML长度,MG长度和Inc长度）对于聚集UCCLP婴儿的肺泡形态至关重要。此外，盲法临床评估表明,肺泡节段呈水平形态的UCCLP患者的治疗结局最低.
结论：总体而言，我们的研究结果为UCCLP婴幼儿牙槽骨形态建立了一个新的定量分类系统,并提示该分类可能与CLP治疗的结局相关.
结论：多学科CLP研究小组在对UCCLP患儿给予PNAM时应彻底评估和分类具体的肺泡形态。
方法：我们收集了90个UCCLP婴儿的数字上颌模型，并进行了数学聚类分析，包括主成分分析(PCA)，决策树建模，和ROC曲线下面积（AUC）分析，对肺泡形态进行分类并确定关键测量值。我们还进行了临床评估，以评估肺泡形态与CLP治疗结果之间的关系。
结果：使用数学聚类分析，我们将肺泡形态分为三种不同的类型：平均形态，水平形式,和纵向形式。决策树模型,AUC分析,和比较分析表明，四个测量(TransACG-ACL，ML长度,MG长度和Inc长度）对于聚集UCCLP婴儿的肺泡形态至关重要。此外，盲法临床评估表明,肺泡节段呈水平形态的UCCLP患者的治疗结局最低.
结论：总体而言，我们的研究结果为UCCLP婴幼儿牙槽骨形态建立了一个新的定量分类系统,并提示该分类可能与CLP治疗的结局相关.
结论：多学科CLP研究小组在对UCCLP患儿给予PNAM时应彻底评估和分类具体的肺泡形态。
