Feichtinger Matthias, Zemann Wolfgang, Mossböck Rudolf, Kärcher Hans
Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 7, A-8036 Graz, Austria.
Br J Oral Maxillofac Surg. 2008 Jun;46(4):278-82. doi: 10.1016/j.bjoms.2007.12.010. Epub 2008 Mar 5.
Secondary bone grafting is widely used in the closure of oronasal fistulas and reconstruction of maxillary defects. It often fails from lack of physiological stress or inadequate covering of the transplanted bone with surrounding tissue. The aim of this study was to assess the exact bone volume after secondary alveolar bone grafting over a period of two years using a navigation system based on computed tomography (CT). We examined 20 patients with complete unilateral cleft lip and palate (UCLP) who had been treated by secondary bone grafting during late mixed dentition. CT scans of the upper jaw were taken immediately preoperatively, and 1 and 2 years postoperatively. The cleft defects and the bony bridges were marked on the monitor. The software of the navigation system created three-dimensional models showing the amount and site of bone resorption. The mean bone loss after one and two years was 51% and 52%, respectively. There was a significant correlation between the size of the cleft and the success of the alveolar bone grafting (p=0.01). When the teeth adjacent to the cleft were missing the amount of bone lost was 95% after the first year. There was also significant bone loss in the buccopalatine direction. Three-dimensional reconstruction of the bony bridges with a navigation system accurately shows the amount of bone within the cleft site. This method is definitely superior to conventional two-dimensional orthopantomography.
二期骨移植广泛应用于口鼻瘘的封闭和上颌骨缺损的重建。它常常因缺乏生理应力或移植骨周围组织覆盖不足而失败。本研究的目的是使用基于计算机断层扫描（CT）的导航系统评估二期牙槽骨移植后两年内的确切骨体积。我们检查了20例单侧完全性唇腭裂（UCLP）患者，他们在混合牙列晚期接受了二期骨移植治疗。在上颌术前即刻、术后1年和2年进行CT扫描。在监视器上标记腭裂缺损和骨桥。导航系统软件创建了三维模型，显示骨吸收的数量和部位。1年和2年后的平均骨丢失分别为51%和52%。腭裂大小与牙槽骨移植成功率之间存在显著相关性（p=0.01）。当腭裂相邻牙齿缺失时，第一年骨丢失量为95%。在颊腭方向也有显著的骨丢失。使用导航系统对骨桥进行三维重建可准确显示腭裂部位的骨量。该方法绝对优于传统的二维曲面断层摄影术。
