Three dimensional maxillary growth modeling in newborns



The aim of this study was to develop an accurate and intuitive semi-automatic segmentation technique to calculate an average maxillary arch and palatal growth profile for healthy newborns in their first year of life.

Materials and methods

Seventy babies born between 1985 and 1988 were included in this study. Each child had five impressions made in the first year after birth that were digitalized. A semi-automatic segmentation tool was developed and used to assess the maxillary dimensions. Finally, random effect models were built to describe the growth and build a simulation population of 10,000 newborns. The segmentation was tested for inter- and intra-observer variability.


The Pearson correlation coefficient for each of the variables was between 0.94 and 1.00, indicating high inter-observer agreement. The paired sample t test showed that, except for the tuberosity distance, there were small, but significant differences in the landmark placements between observers. Intra-observer repeatability was high, with Pearson correlation coefficients ranging from 0.87 to 1.00 for all measurements, and the mean differences were not significant. A third or second degree growth curve could be successfully made for each parameter.


These findings indicated this method could be used for objective clinical evaluation of maxillary growth.

Clinical relevance

The resulting growth models can be used for growth studies in healthy newborns and for growth and treatment outcome studies in children with cleft lip and palate or other craniofacial anomalies.

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Author information




R. Bruggink contributed to the conception, design, data digitalization, data analysis, interpretation, and drafted and critically revised the manuscript. F. Baan contributed to data analysis and drafted and critically revised the manuscript. G.J.C. Kramer contributed to data acquisition and critically revised the manuscript. E.M. Bronkhorst contributed to statistical analysis and critically revised the manuscript. T.J.J. Maal, A.M. Kuijpers-Jagtman, S.J. Bergé, and E.M. Ongkosuwito contributed to the conception, design, data interpretation and critically revised the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to R. Bruggink.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The present study was approved by the Research Ethics Committee (CMO), Region Arnhem/Nijmegen, The Netherlands (2016-2654).

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

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Bruggink, R., Baan, F., Kramer, G.J.C. et al. Three dimensional maxillary growth modeling in newborns. Clin Oral Invest 23, 3705–3712 (2019).

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  • Orthodontics
  • Dental models
  • Imaging, three-dimensional
  • Palate
  • Diagnostic imaging
  • Maxillofacial development