Siddharth Vora

Assistant Professor

Research Classification

Research Interests

Cleft lip and/or palate
Craniofacial Biology
Developmental biology
Oro-Dental Disorders
Orthodontics
Tooth development

Relevant Degree Programs

 
 

Research Methodology

3D-imaging and analysis
Geometric morphometrics

Recruitment

Master's students
Doctoral students
Any time / year round
I support public scholarship, e.g. through the Public Scholars Initiative, and am available to supervise students and Postdocs interested in collaborating with external partners as part of their research.
I support experiential learning experiences, such as internships and work placements, for my graduate students and Postdocs.
I am open to hosting Visiting International Research Students (non-degree, up to 12 months).

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Graduate Student Supervision

Master's Student Supervision (2010 - 2020)
Ontogeny of the human fetal tongue, mandible, and hyoid cartilage (2020)

BACKGROUND: Growth characteristics of the human craniofacial region during the fetal stages of development remain largely unexplored. This project investigates the growth of the human tongue, mandible and hyoid cartilage, during the early fetal stage, using a rare collection of preserved fetal head tissues. These structures differ in the tissue types that they are comprised of, however, they share common developmental origins. We hypothesized that the growth of these tissues exhibits a strong positive correlation during prenatal human life.MATERIALS AND METHODS: Human fetal heads were obtained from elective terminations between nine and nineteen postconceptional weeks (n=16). They were contrast-enhanced with phosphotungstic acid (PTA) and imaged with high-resolution micro-CT. Segmentation of the tongue, mandible, and hyoid cartilage was performed, three-dimensional models were constructed, and their volumes were calculated. To assess the relationship between the variables, correlations between different tissues were determined. Additionally, regression analyses were performed after normalization of data to permit comparisons between the different tissues. A single-rater interclass correlation coefficient was performed for 5 randomly selected samples, to study the measurement reliability.iiiRESULTS: PTA contrast enhancement provides excellent visualization and allows for accurate digital segmentation of hard and soft tissues of the craniofacial regions in the fetal head samples. Pearson’s correlation coefficients of 0.96, 0.85, and 0.91 were calculated between the growth of the tongue – hyoid, tongue – mandible, and mandible-hyoid, respectively. The mandibular bone showed a similar growth trajectory as the tongue and the hyoid cartilage. However, the growth of the tongue was found to precede the mandibular growth, albeit slightly, at day 109.6 pc. Interclass correlation coefficient for all repeated measurements were > 0.9 with a P
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Outcome assessment of facial orthopedics with taping for taping for cleft lip deformities using 3D (2020)

Background: Prior to operative correction of a cleft lip, presurgical orthopaedics (PSO) with facial taping is used to improve pre-maxillary and soft tissue alignment. Two commercially available taping systems, Dynacleft and 3MTM taping are used at the British Columbia Children’s Hospital for this purpose. The aim of this study was to evaluate 3MTM and Dynacleft tape, for their ability to impact nasolabial shape during the treatment of the cleft lip deformity. Methods: A retrospective cohort study of 93 cleft lip +/- palate patients (69 unilateral, 24 bilateral) that had received either Dynacleft or 3MTM facial taping was conducted. 3D stereophotogrammetry images were obtained at three time-points: prior to treatment, after receiving taping but prior to surgery and after surgical repair. 3D photos were annotated with landmarks on the nasolabial region using 3DMD Vultus software. The landmarks were then used in conventional morphometric analysis with previously validated facial measurements to describe and compare the two cohorts at each stage. Geometric morphometrics using Procrustes ANOVA analysis was also conducted to compare the nasolabial shape between the two taping groups. Unilateral cleft patients were additionally compared by their presenting cleft severity using both morphometric analyses to evaluate the impact of presenting severity on cleft outcomes. Results: Both taping devices demonstrated progressive improvement in multiple facial metrics after taping and after surgery. Although variability in the degree of improvement was noted in the evaluated facial metrics after pre-surgical orthopedics between the two taping groups, no differences were found between these metrics after surgery. ANOVA comparison of the nasolabial region after Procrustes analysis also found no significant difference between the two taping cohorts after surgical cleft lip repair (p-value =0.57). Unilateral cleft patients classified as severe at presentation had residual facial shape differences after lip repair compared to milder presenting clefts (p-value=0.005)Conclusions: PSO with facial taping reduces the cleft facial deformity prior to surgical correction across multiple facial measurements. However, both 3M and Dynacleft taping devices result in similar facial alignment post-operatively suggesting either can be successfully utilized and that differences prior to surgery have limited influence on the post-operative result.

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The influence of the spheno occipital synchondrosis fusion on craniofacial form (2020)

Introduction: Growth of the facial skeleton is integrated to growth of the cranial base. This relationship is highlighted in patients with craniosynostosis syndromes in whom premature fusion of cranial base synchondroses, including the spheno-occipital synchondrosis (SOS), is associated with severe midface deficiency. Objectives: To evaluate the relationship between SOS fusion and craniofacial morphology in non-syndromic individuals – specifically midface projection and skeletal Class III phenotype. Methods: 250 pre-treatment cone-beam computed tomography images were studied from a collection of orthodontic patients’ records, aged 5-11 years (M = 99, F = 151, average age = 8.77 years). SOS fusion was scored using a 6-stage SOS fusion scale utilizing InVivoDental (v6). 3D Slicer (v4.10.2) was used to place three-dimensional landmarks. Error analysis was performed by repeat landmarking of 12 volumes (mean error = 0.23 mm). X, Y, Z coordinates for landmarks were used to determine linear and angular craniofacial measurements. Geometric morphometric (GM) analyses were used to describe facial shape variation. Results: There is a large variation in SOS fusion stage, with older children tending to have a higher fusion stage than younger children. While SOS stage is correlated with subject age, no statistically significant relationships were noted in the age of SOS stages between the Skeletal Class I, II, and III groups for males or females. There were no statistically significant findings of SOS stage as it relates to age or the linear and angular craniofacial measurements in this study, except A Point – Nasion – B point angle being decreased in SOS stage 3 compared to SOS stage 2. The GM analyses suggests that SOS stage, sex, and skeletal class do correlate with craniofacial morphology. Conclusions: This data suggests that younger children with early fusion of the SOS may display a skeletal pattern which is similar to a skeletal Class III morphology. SOS stage is more closely correlated to facial morphology differences of increased mandibular length and transverse facial width. Maxillary projection is also found to be correlated with sex and skeletal class. Further investigation is needed to assess how fusion of the SOS may affect orthodontic and orthopedic treatments for midface deficiency.

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