Exploring the potential applications of intraoral scanners in the treatment of cleft lip and palate deformity-A scoping review of literature

Abstract

Background: In the realm of cleft lip and palate (CLP) care, the integration of intraoral scanners (IOS) may offer a promising avenue, enabling precise digital imaging, record-keeping, treatment planning and execution. This scoping review aimed to explore the current applications of IOS in CLP patients and discuss potential future directions for optimizing the utilization of IOS in cleft care.

Material and methods: The review was registered apriori in the Open Science Framework (OSF) Registries (https://doi.org/10.17605/OSF.IO/KPD34). A systematic search was conducted across various databases like Ovid MEDLINE, PubMed, Cochrane Library, Embase, Web of Science, Scopus, Google Scholar, Grey literature, and Trial registries using a broad search strategy. The articles published in any language till December 20, 2023 were considered. Studies that demonstrated the application of intraoral scanning in nonsyndromic CLP patients were included. A validated sixteen-item content assessment tool was used to evaluate the included studies. Two independent reviewers performed data extraction and content assessment.

Results: Fifteen research studies and thirteen case reports/series were included in the final analysis. Various applications included capturing intraoral and extraoral images, scanning orthodontic study models, assessing dental changes, monitoring treatment changes related to nasoalveolar molding therapy, and fabricating appliances. The content assessment showed below-average mean scores of 34.79 ± 9.37% for research studies and 39.7 ± 0.14% for case reports/series. This can be attributed to insufficient information on scanning parameters, methodology, accuracy, patient outcomes, limitations, and potential solutions. The reproducibility of landmark identification in IOS was within 0.2 mm. Patients and caregivers preferred digital impressions over traditional alginate methods, reporting positive experiences in 84.8% of cases.

Conclusion: Intraoral scanners offer good clinical accuracy and validity in assessing dentofacial and nasolabial morphology in cleft patients. Adopting IOS can streamline clinical workflows, enhance treatment accuracy, and improve patient outcomes in managing cleft lip and palate.

Keywords: Cleft care; Cleft lip; Cleft palate; Intraoral scanner; Review.