Measuring Defect Volume in Alveolar Clefts: Systematic Review and Four Workflows Using Slicer Software
Inka Saraswati(a*), Menik Priaminiarti(a), Bramma Kiswanjaya(a)

(a) Dentomaxillofacial Radiology Department, Faculty of Dentistry, Universitas Indonesia
Jakarta, Indonesia

*inkasaraswati[at]office.ui.ac.id

Abstract

Background: Alveolar clefts, occurring in cleft lip and/or palate (CL/P), need to be closed by bone grafts to facilitate canine eruption, close oronasal fistulas, improve nasal symmetry, and promote dental health. Volumetric information about the size of alveolar clefts can be extracted from 3D X-ray images, adding value to patient treatment without additional risks.
Objectives: The objectives were to evaluate the variety of workflows available to measure alveolar defect volume and apply these workflows in Slicer, a free and open-source software.
Method: This review was developed based on PRISMA guidelines. The search was conducted on Scopus, Embase, PubMed, and additional sources without time restrictions. Methodological quality was assessed, and a qualitative synthesis of the workflows was obtained. Based on previously described workflows, we explored their applications in Slicer software.
Result: Seventeen articles met the predefined criteria. Identified workflows included tracing each slice, tracing multiple slices, orthogonal tracing, mirrored templates, cuboid formulas, region growing, and AI. We also propose four specific workflows for alveolar cleft measurement using Slicer software: tracing manually, tracing each slice with interpolation, voxel-based registration, and landmark-based registration.
Conclusion: The most commonly investigated workflow was tracing each slice, but there is a lack of quality studies on measuring alveolar defects. Slicer was able to recreate several workflows, allowing for application with little to no cost.

Keywords: 3D imaging, cleft lip, cleft palate, volume

Topic: Oral Radiology