***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Alveolar bone grafting is a st and ard procedure used to achieve good occlusion for both functional and aesthetic purpose s in patients with cleft lip and palate . At the past , main methods used to evaluate bone bridge formation after bone grafting are radiographs , such as dental , occlusal , and panoramic . PURPOSE To evaluate bone bridge both qualitatively and quantitatively , we used CT scans ( conventional and QCT ) . Quantitative computed tomography ( QCT ) has previously been used for measuring bone mineral density of the lumbar vertebrae . PATIENTS AND METHODS The study comprised 26 male and 15 female patients who underwent alveolar bone grafting .  We analyzed bone bridge with regard to four factors : marginal bone level , vertical height , anteroposterior bone width and bone mineral density using dental radiographs , and CT scans such as conventional and QCT . The clinical results of orthodontic treatment were evaluated more than 2 years postoperatively . RESULTS Orthodontic treatment was considered to be successful when the bone bridge satisfied the following criteria : marginal bone level > = 3 , vertical height > = 6.5 mm , anteroposterior bone width > = 5 mm , and bone mineral density < 350 mg Ca(5 ) ( PO(4 ) ) OH/mL. CONCLUSION we could predict the prognosis of patients ' orthodontic treatment in early stage after bone grafting PURPOSE The aim of this study was to assess the 3-dimensional facial surface changes after  cleft alveolar bone grafting  with digital surface photogrammetry . PATIENTS AND METHODS In a prospect i ve study , 22 patients with cleft lip and palate underwent alveolar bone grafting .  Before the procedure and 6 weeks postoperatively and before the continuation of orthodontic treatment , 3-dimensional images were taken with digital surface photogrammetry . Seven st and ard craniofacial l and marks on the nose and the upper lip were identified . Their spatial change because of bone grafting was assessed . Statistical analysis was performed with analysis of variance and t test . RESULTS A significant increase in anterior projection on the operative side ( P < .05 ) was found for the labial insertion points of the alar base ( subalare ) . No significant changes were detected for the position of the labial l and marks . CONCLUSION Our results show 3-dimensionally that there is a positive influence of the alveolar bone graft on the projection of the alar base on the cleft side Yardsticks have been developed to measure dental arch relations in cleft lip and palate ( CLP ) patients as diagnostic proxies for the underlying skeletal relationship . Travelling with plaster casts to compare results between CLP centres is inefficient so the aim of this study was to investigate the reliability of using digital models or photographs of dental casts instead of plaster casts for rating dental arch relationships in children with complete bilateral cleft lip and palate ( CBCLP ) . Dental casts of children with CBCLP ( n=20 ) were included .  Plaster casts , digital models and photographs of the plaster casts were available for all the children at 6 , 9 , and 12 years of age . All three record formats were scored using the bilateral cleft lip and palate ( BCLP ) yardstick by four observers in r and om order . No significant differences were found for the BCLP yardstick scores among the three formats . The interobserver weighted kappa scores were between 0.672 and 0.934 . Comparison between the formats per observer result ed in weighted kappa scores between 0.692 and 0.885 . It is concluded that digital models and photographs of dental casts can be used for rating dental arch relationships in patients with CBCLP . These formats are a reliable alternative for BCLP yardstick assessment s on conventional plaster casts OBJECTIVES To evaluate the reliability of clinical assessment , two-dimensional color transparencies and three-dimensional imaging for evaluating the residual facial deformity in patients with repaired complete unilateral cleft lip and palate ( UCLP ) and compare the ratings of facial deformity made by health care professionals with those made by lay assessors . PATIENTS AND PARTICIPANTS Thirty-one r and omly selected subjects aged 10 to 30 years with repaired complete UCLP . Five professionals and five laypersons evaluated each subject 's residual cleft-related facial deformity using clinical assessment , two-dimensional color transparencies , and three-dimensional images . MAIN OUTCOME MEASURES The facial deformity of the full face , lip , nose , and midface were scored using a 5-point ordinal scale on two occasions with a 1-month interval . Intra- and interexaminer agreements were calculated from weighted kappa statistics . Bootstrap permutation tests were used to detect any differences in agreement . RESULTS Assessment of facial deformity showed good reproducibility across the three assessment media ( kappa = 0.42 to 0.83 , SE 0.08 ) . Clinical assessment among lay assessors , however , was poor to moderate ( kappa = 0.16 to 0.58 , SE 0.07 ) . For all assessors , there was no difference in the two non clinical media relative to the st and ard clinical assessment for assessment s of the full face ( p = .377 ) . For assessment s of the lip or nose , transparency scores were in greater agreement with the clinical scores than were the three-dimensional assessment scores ( p = .017 and .011 , respectively ) . For rating the midface , the three-dimensional scores were in greater agreement with the clinical scores than were the color transparencies scores ( p = .047 ) . CONCLUSIONS In comparison with lay assessors , clinical assessment among professionals was more reproducible . This was not so for non clinical media . The equivalence of using the color transparencies and three-dimensional media relative to the clinical assessment depends on the region of the face being considered Aim : Rapid Maxillary Expansion ( RME ) and Delaire facemask are a well-established treatment method for patients with cleft lip and palate and Class III malocclusion . Several roentgenocephalometric studies on skeletal effects of this therapy are known . However , there are no systematic studies on soft tissue changes . The aim of this study was to analyze three-dimensionally the soft tissue changes in facial morphology of children with cleft lip and palate and Class III malocclusion under therapy with RME and Delaire facemask .  Patients and Method : A prospect i ve longitudinal clinical trial was undertaken . 29 children between 4.1 and 6.4 years were divided into four groups : eight patients with unilateral cleft lip and palate ( group 1 ) , six patients with isolated cleft palate ( group 2 ) , eight patients with Class III malocclusion ( group 3 ) . The mean treatment period with RME and Delaire mask was 8.2 months . Seven untreated children with no need of orthodontic treatment were chosen as the control ( group 4 ) . Two 3D images , one at the beginning and one at the end of the study , were generated with the DSP 400 © imaging system . Both images were superimposed ten times and measured ten times . Results : We detected significant forward rotation and forward displacement of the soft tissue in the lower midface with the dentoalveolar areas in all patient groups . No significant asymmetric forward displacement of the soft tissue in the maxilla could be verified in the lower or upper midface , not even in the unilateral cleft lip and palate patients . Among the groups , the Class III malocclusion patients showed greater maxillary soft tissue changes . Conclusion : The RME and the Delaire facemask demonstrated the greatest effectiveness in the lower midface soft tissue in terms of forward displacement and forward rotation in the cleft lip and palate patients , particularly in the Class III patients . The 3D data allowed us to discriminatively interpret the effects of the orthopedic mask on the entire maxillary complex and maxillary alveolar process . In the unilateral cleft lip and palate patients , there was descriptively both symmetric and asymmetric advancement of the midface soft tissue . ZusammenfassungZiel : Die Gaumennahterweiterung ( GNE ) und Delaire-Maske stellen ein etabliertes Therapieverfahren bei Patienten mit Lippen- Kiefer-Gaumen-(LKG-)Spalten und Klasse-III-Anomalien dar . Viele röntgenkephalometrische Studien zum skelettalen Effekt dieser Therapie liegen vor . Systematische Untersuchungen zu Weichgewebeveränderungen fehlen jedoch . Ziel dieser Studie war es , die Weich gewebeveränderungen der Gesichtsmorphologie von Kindern mit Spaltbildungen und Klasse-III-Anomalien unter Therapie mit GNE und Delaire-Maske dreidimensional aufzuzeigen . Patienten und Method ik : Es wurde eine klinische prospektive Longitudinaluntersuchung mit 29 in vier Gruppen eingeteilten Kindern zwischen 4,1 und 6,4 Jahren durchgeführt . Acht Patienten mit einseitiger LKG-Spalte ( Gruppe 1 ) , sechs mit isolierter Gaumenspalte ( Gruppe 2 ) und acht mit Klasse-III-Anomalie ( Gruppe 3 ) wurden i m Durchschnitt 8,2 Monate mit GNE und Delaire-Maske beh and elt und untersucht . Sieben unbeh and elte Kinder ohne kieferorthopädischen Beh and lungsbedarf dienten als Kontrolle ( Gruppe 4 ) . Zwei 3D-Abbildungen , eine zum Untersuchungsbeginn und eine zum Untersuchungsende , wurden mit dem DSP-400 © -System generiert , zehnfach überlagert und zehnfach vermessen . Ergebnisse : In allen Gruppen konnte eine signifikante Vorschwenkung und Vorverlagerung des Weichgewebes i m unteren Mittelgesicht mit den dento-alveolären Bereichen nachgewiesen werden . Keine signifikante asymmetrische Vorverlagerung der Maxilla , weder i m unteren noch i m oberen Mittelgesicht , konnte beobachtet werden – auch nicht bei den einseitigen LKG-Spalten . Zwischen den Gruppen zeigten die Klasse-III-Patienten die größeren maxillären Weichgewebeveränderungen . Schlussfolgerungen : Die GNE und die Delaire-Maske zeigten bei den Spaltpatienten und vor allem bei den Klasse-III-Patienten eine deutliche Beeinflussbarkeit auf das Weichgewebe i m Sinne einer Vorverlagerung und einer Vorschwenkung i m unteren Mittelgesicht . Die Wirkungen der orthopädischen Maske auf den gesamten Maxillakomplex sowie auf den maxillären Alveolarfortsatz ließen sich anh and der  3D- Date n unterschiedlich interpretieren . Bei einseitigen LKG-Spalten kam es i m Mittelgesicht deskriptiv sowohl zu symmetrischer als auch asymmetrischer Vorverlagerung des Weichgewebes OBJECTIVE To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate ( CLP ) . DESIGN , SETTING , AND PATIENTS The three-dimensional coordinates of soft tissue facial l and marks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP ( 11 males and 7 females aged 19 to 27 years ) and 162 healthy controls ( 73 females and 89 males aged 18 to 30 years ) . From the l and marks , 15 facial dimensions and two angles were calculated . Data were compared with those collected in healthy individuals by computing z-scores . Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects : the mean z-score ( an index of overall facial size ) , and its SD , called the craniofacial variability index ( an index of facial harmony ) . RESULTS In treated patients with CLP , facial size was somewhat smaller than in normal individuals , but in all occasions the mean z-score fell inside the normal interval ( mean + /- 2 SD ) . Almost all patients had a craniofacial variability index larger than the normal interval , indicating a global disharmonious appearance . Overall , in patients pronasale , subnasale , and pogonion were more posterior , the nose was shorter and larger , the face was narrower , and the soft tissue profile and upper lip were flatter than in the reference population . CONCLUSIONS The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age , sex , and ethnic group . In this patient group , surgical corrections of CLP failed to provide a completely harmonious appearance , even if the deviations from the reference were limited . Further analyses of larger groups of patients are needed Objective To evaluate three-dimensional nasal morphology following primary reconstruction in children with unilateral cleft lip and palate relative to contemporaneous noncleft data . Design Prospect i ve , cross-sectional , controlled study . Setting Glasgow Dental Hospital and School , Faculty of Medicine , Glasgow University . Patients and Participants Two groups of 3-year-old children ( 21 with unilateral cleft lip and palate and 96 controls ) with facial images taken using a three-dimensional , vision-based capture technique .  Method Three-dimensional images of the face were reflected so the cleft was on the left side to create a homogeneous group for statistical analysis . Three-dimensional coordinates of anthropometric l and marks were extracted from facial images by a single operator . A set of linear measurements was used to compare cleft and control subjects on right and left sides , adjusting for sex differences . Results The mean nasal base width and the width of the nostril floor on right and left sides differed significantly between control and unilateral cleft lip and palate groups . The measurements were greater in children with unilateral cleft lip and palate . The differences in the mean nasal height and mean nasal projection between the groups were not statistically significant . Mean columellar lengths were different between the left and right sides in children with unilater 
    Output:
    
These techniques are mainly used for soft tissue analysis , evaluation of bone grafting , and changes in the craniofacial skeleton .
Digital dental casts are used to evaluate treatment and changes over time .
Available evidence implies that 3D imaging methods can be used for documentation of CLP patients .
No data are available yet showing that 3D methods are more informative than conventional 2D methods .