{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:59:17Z","timestamp":1776405557435,"version":"3.51.2"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dent. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary cheiloplasty is the first definitive surgical intervention for infants with cleft lip and plays a central role in establishing the foundation of postoperative nasolabial morphology. Because the early configuration of the lip and nose can influence long-term facial harmony, achieving an anatomically favorable morphology at the time of initial surgery is an important clinical objective. At our institution, primary cheiloplasty is performed using the Cronin method in combination with nasal vestibular expansion (NVE), a technique designed to improve symmetry by simultaneously repositioning the soft tissues of both the lip and the nose. However, the extent and pattern of nasolabial morphological change during the early postoperative period and throughout the first year of growth remain insufficiently understood. This study therefore aims to longitudinally investigate postoperative changes in nasolabial morphology following primary cheiloplasty performed using the Cronin method with NVE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty children with unilateral complete cleft lip were included in this study. Three-dimensional (3D) soft-tissue images were obtained using the Vectra H1\u00ae system at 1, 3, and 6 months and 1 year after surgery. An image analysis was performed using HBM-Rugle\u00ae, and symmetry was assessed by comparing the affected and non-affected sides. A reference plane was defined using the bilateral endocanthion points and the alar base point on the non-cleft side to ensure consistent spatial measurement of 3D coordinates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cleft-to-non-cleft side ratios of the alar base were 0.85\u20130.93 for the\n                      <jats:italic>X<\/jats:italic>\n                      -coordinate, 1.01\u20131.07 for the\n                      <jats:italic>Y<\/jats:italic>\n                      -coordinate, and 1.06\u20131.22 for the\n                      <jats:italic>Z<\/jats:italic>\n                      -coordinate across the four time points. Ratios for white-lip length were 0.86, 0.86, 0.84, and 1.02, whereas nasal-floor length ratios were 1.31, 1.38, 1.50, and 1.41. These trends indicated a slight deterioration in anteroposterior symmetry of the alar base and nasal floor over the first postoperative year, while white-lip length progressively improved and approached near-symmetry by 1 year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This longitudinal 3D analysis demonstrates region-specific postoperative changes within the nasolabial complex, suggesting that individual anatomical components exhibit distinct growth or relapse patterns. These findings may help refine surgical planning and early postoperative management aimed at optimizing nasolabial morphology following primary cheiloplasty with NVE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdmed.2026.1783578","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:23:05Z","timestamp":1776403385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A longitudinal three-dimensional analysis of nasolabial morphology following primary cheiloplasty of unilateral cleft lip deformity"],"prefix":"10.3389","volume":"7","author":[{"given":"Kei","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Ishihata","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoko","family":"Tsuruda","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinki","family":"Serizawa","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiko","family":"Kurosaka","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namiko","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Tezuka","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiro","family":"Kibe","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Yamanishi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Osaka Women\u2019s and Children\u2019s Hospital","place":["Osaka, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideto","family":"Saijo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences","place":["Kagoshima, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e41683","DOI":"10.7759\/cureus.41683","article-title":"Long-term nasolabial appearance post-unilateral cleft lip repair in a single center: a descriptive study","volume":"15","author":"Al-Chalabi","year":"2023","journal-title":"Cureus"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1016\/j.ijom.2025.04.008","article-title":"Comparison of a third surgical protocol for the treatment of unilateral cleft lip and palate: a multidisciplinary systematic review and meta-analysis","volume":"54","author":"van Roey","year":"2025","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1054\/jcms.2001.0217","article-title":"The Eurocleft project 1996-2000: overview","volume":"29","author":"Shaw","year":"2001","journal-title":"J Craniomaxillofac Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e442","DOI":"10.1097\/GOX.0000000000000415","article-title":"The americleft project: burden of care from secondary surgery","volume":"3","author":"Sitzman","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2943","DOI":"10.3390\/jcm11102943","article-title":"Nasolabial appearance in 5-year-old patients with repaired complete unilateral cleft lip and palate: a comparison of two different techniques of lip repair","volume":"11","author":"Lux","year":"2022","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"7501","DOI":"10.3390\/jcm14217501","article-title":"Aesthetics are in the eye of the beholder: evaluation of the nasolabial appearance after primary cleft lip repair","volume":"14","author":"Ivanic-Sefcikova","year":"2025","journal-title":"J Clin Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/ocr.12765","article-title":"Nasolabial morphological changes in patients with unilateral cleft lip and palate using a Korat-modified nasoalveolar moulding appliance with primary correction","volume":"27","author":"Nirunrungrueng","year":"2024","journal-title":"Orthod Craniofac Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1177\/10556656241256706","article-title":"A longitudinal investigation of nasolabial changes with and without revision surgery in patients with non-syndromic unilateral cleft lip and palate","volume":"62","author":"Dabbagh","year":"2025","journal-title":"Cleft Palate Craniofac J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1136467","DOI":"10.3389\/fped.2023.1136467","article-title":"Growth patterns of the nasolabial region following unilateral cleft lip primary repair","volume":"11","author":"Xu","year":"2023","journal-title":"Front Pediatr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1597\/1545-1569_1992_029_0303_agsoth_2.3.co_2","article-title":"Anthropometric growth study of the head","volume":"29","author":"Farkas","year":"1992","journal-title":"Cleft Palate Craniofac J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1597\/12-317","article-title":"Short-term molding effects on the upper alveolar arch following unilateral cleft lip repair with\/without nasal vestibular expansion","volume":"51","author":"Fuchigami","year":"2014","journal-title":"Cleft Palate Craniofac J"},{"key":"B12","first-page":"376","article-title":"A modification of the tennison-type lip repair","volume":"3","author":"Cronin","year":"1966","journal-title":"Cleft Palate Craniofac J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1177\/10556656231175554","article-title":"Three-dimensional evaluation of nasolabial morphology after applying presurgical nasoalveolar molding in primary unilateral cheiloplasty using the modified millard technique","volume":"61","author":"Ho Nguyen","year":"2024","journal-title":"Cleft Palate Craniofac J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"cjaf051","DOI":"10.1093\/ejo\/cjaf051","article-title":"Nasolabial shape and aesthetics in patients with cleft lip and palate: analysis of 3D facial images","volume":"47","author":"Schmutz","year":"2025","journal-title":"Eur J Orthod"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2222","DOI":"10.1016\/j.joms.2009.04.098","article-title":"Postoperative nasal forms after presurgical nasoalveolar molding followed by medial-upward advancement of nasolabial components with vestibular expansion for children with unilateral complete cleft lip and palate","volume":"67","author":"Nakamura","year":"2009","journal-title":"J Oral Maxillofac Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.jcms.2018.11.035","article-title":"Three-dimensional analyses of nasolabial forms and upper lip surface symmetry after primary lip repair in patients with complete unilateral cleft lip and palate","volume":"47","author":"Kimura","year":"2019","journal-title":"J Craniomaxillofac Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1054\/jcms.2002.0320","article-title":"Three-dimensional facial morphology, following primary cleft lip repair using the triangular flap with or without rotation advancement","volume":"30","author":"Yamada","year":"2002","journal-title":"J Craniomaxillofac Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.jcms.2006.03.001","article-title":"Nasolabial symmetry following Tennison-Randall lip repair: a three-dimensional approach in 10-year-old patients with unilateral clefts of lip, alveolus and palate","volume":"34","author":"Bilwatsch","year":"2006","journal-title":"J Craniomaxillofac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1597\/04-138.1","article-title":"Determination of facial symmetry in unilateral cleft lip and palate patients from three-dimensional data: technical report and assessment of measurement errors","volume":"43","author":"Nkenke","year":"2006","journal-title":"Cleft Palate Craniofac J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1007\/s00056-008-0746-1","article-title":"Dreidimensionale Analyse der Gesichtssymmetrie von Patienten mit einseitiger Lippen-Kiefer-Gaumen-Spalte anhand optischer Oberfl\u00e4chendaten","volume":"69","author":"Stauber","year":"2008","journal-title":"J Orofac Orthop"},{"key":"B21","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1054\/bjps.2001.3682","article-title":"Correction of cleft lip nasal deformity in orientals using a refined reverse-U incision and V-Y plasty","volume":"54","author":"Cho","year":"2001","journal-title":"Br J Plast Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1054\/bjom.1999.0132","article-title":"A comparison of growth impairment and orthodontic. Results in adult patients with clefts of palate and unilateral clefts of lip, palate and alveolus","volume":"38","author":"Schultes","year":"2000","journal-title":"Br J Oral Maxillofac Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1007\/s12663-020-01412-0","article-title":"Management of the nasal deformity in the unilateral cleft of the lip and nose","volume":"19","author":"Bonanthaya","year":"2020","journal-title":"J Maxillofac Oral Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1156275","DOI":"10.3389\/fped.2023.1156275","article-title":"Correction of narrow nostril deformity secondary to cleft lip: indications for different surgical methods and a retrospective study","volume":"11","author":"Wei","year":"2023","journal-title":"Front Pediatr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1051\/mbcb\/2025017","article-title":"Nasal deformities in cleft lip and palate: an update for dental professionals","volume":"31","author":"Ghazal","year":"2025","journal-title":"J Oral Med Oral Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.ijom.2022.07.011","article-title":"Stability of nasal symmetry following primary cleft lip and nasal repair: five years of follow-up","volume":"52","author":"Alkebsi","year":"2023","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1597\/16-073","article-title":"Three-dimensional analysis of nasal symmetry following primary correction of unilateral cleft lip nasal deformity","volume":"54","author":"Linden","year":"2017","journal-title":"Cleft Palate Craniofac J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.ajoms.2017.05.011","article-title":"Changes in the length over time to the triangular flap in the Cronin method","volume":"29","author":"Shimohira","year":"2017","journal-title":"J Oral Maxillofac Surg Med Pathol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1089\/fpsam.2022.0058","article-title":"Novel reconstruction of orbicularis oris in unilateral complete cleft lip repair","volume":"25","author":"Liu","year":"2023","journal-title":"Facial Plast Surg Aesthet Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.ijom.2019.10.010","article-title":"Influence of different techniques of secondary cleft lip revision surgery on upper lip projection","volume":"49","author":"Schwaiger","year":"2020","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e18739","DOI":"10.7717\/peerj.18739","article-title":"Three-dimensional analysis of facial morphology in nine-year-old children with different unilateral orofacial clefts compared to normative data","volume":"13","author":"Crins-De Koning","year":"2025","journal-title":"PeerJ"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1016\/j.ijom.2018.05.017","article-title":"Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate: a systematic review","volume":"47","author":"Thierens","year":"2018","journal-title":"Int J Oral Maxillofac Surg"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1007\/s00784-011-0615-y","article-title":"A longitudinal three-center study of craniofacial morphology at 6 and 12 years of age in patients with complete bilateral cleft lip and palate","volume":"16","author":"Bartzela","year":"2012","journal-title":"Clin Oral Investig"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1016\/j.ajoms.2025.05.004","article-title":"Craniofacial growth patterns of female patients with cleft lip and\/or palate: a longitudinal study from infancy to adolescence","volume":"37","author":"Suzuki","year":"2025","journal-title":"J Oral Maxillofac Surg Med Pathol"}],"container-title":["Frontiers in Dental Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1783578\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:23:06Z","timestamp":1776403386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1783578\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":34,"alternative-id":["10.3389\/fdmed.2026.1783578"],"URL":"https:\/\/doi.org\/10.3389\/fdmed.2026.1783578","relation":{},"ISSN":["2673-4915"],"issn-type":[{"value":"2673-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"article-number":"1783578"}}