Toward Precision Radiologic Assessment in Alveolar Cleft Reconstruction: From 2-Dimensional Scoring to Artificial Intelligence-Integrated 3-Dimensional Modeling.

BACKGROUND

Radiological evaluation is critical for determining alveolar bone grafting success. Assessment has evolved from subjective two-dimensional (2D) scoring to objective three-dimensional (3D) quantitative imaging using cone-beam computed tomography (CBCT). Recently, artificial intelligence (AI) has emerged as a potentially valuable tool. This review examines this evolution and identifies future directions for more precise radiologic assessment in alveolar cleft reconstruction.

FINDINGS: Traditional 2D scoring remains widely used but is limited by distortion and poor volumetric assessment. CBCT-based 3D imaging enables more objective evaluation of graft morphology and postoperative healing. AI-assisted approaches may support image analysis and prognostic assessment, but clinical application remains limited.

CONCLUSIONS AND RELEVANCE: Radiologic assessment in alveolar cleft reconstruction has evolved from subjective 2D scoring to objective 3D imaging, with CBCT currently representing the most informative approach and AI emerging as a potential adjunct for future precision evaluation.