Three-dimensional stereophotogrammetry vs. standard measurements for soft tissue and dental arches analysis in cleft lip and palate: Systematic review.

BACKGROUND

Cleft lip and palate (CLP) are the most prevalent congenital anomalies, often resulting in impaired maxillofacial complex in all three planes of space and maxillary growth deficiency, leading to aesthetic and functional challenges. Traditional methods like calipers and rulers have limitations in precision, reproducibility, and volumetric capture for soft tissues (ST) and dental arches (DA) in CLP patients. Three-Dimensional Stereophotogrammetry (3DS) offers a non-invasive digital alternative for accurate 3D imaging. The aim of this systematic review of comparative studies was to evaluate 3DS versus standard measurements (SM) for ST and DA analysis in CLP.

MATERIAL AND

METHODS

This study identified comparative studies in humans. Six electronic databases were searched to find articles meeting the eligibility criteria up to December 2025, without language or date restrictions. Risk of bias for each included study was assessed using the 4-stage quality assessment tool for diagnostic accuracy studies (QUADAS-2). Data on outcomes of interest were extracted and tabulated. Due to methodological heterogeneity, a qualitative synthesis was performed, with quantitative evaluation where possible; no meta-analysis was conducted.

RESULTS

From 788 records (413 PubMed, 150 ScienceDirect, 47 Scopus, 34 Web of Science, 8 Cochrane, 136 manual/gray literature), 85 underwent full-text review, yielding 7 studies (269 patients, mean age 12 years, primarily unilateral CLP). Despite methodological heterogeneity among studies, 3DS marked different landmarks in the cleft area (CA) and DA models. There was individual consensus on the accuracy and reproducibility of 3DS markings compared to other methods, and all studies showed low risk of bias in applicability and no meta-analysis due to variability.

CONCLUSIONS

All included studies demonstrated that, despite minor methodological differences, digital measurements using 3DS in patients with unilateral cleft lip and palate (UCLP) were more accurate and highly reliable than SM. Future standardized studies are needed for meta-analysis.