Oberoi Snehlata, Chigurupati Radhika, Gill Pawandeep, Hoffman William Y, Vargervik Karin
Center for Craniofacial Anomalies, Department of Orofacial Sciences, University of California at San Francisco, 94143, USA.
Cleft Palate Craniofac J. 2009 Sep;46(5):503-11. doi: 10.1597/08-153.1. Epub 2009 Feb 27.
To assess the radiographic outcome of secondary alveolar bone grafting in individuals with nonsyndromic unilateral or bilateral cleft lip and palate using cone beam computed tomography.
This prospective study was conducted at the University of California at San Francisco Center for Craniofacial Anomalies on 21 consecutive nonsyndromic complete cleft lip and palate individuals between 8 and 12 years of age who required alveolar bone grafting. Seventeen unilateral and four bilateral cleft lip and palate individuals had preoperative and postoperative cone beam computed tomography scans that were analyzed using Amira 3.1.1 software.
The average volume of the preoperative alveolar cleft defect in unilateral cleft lip and palate was 0.61 cm(3), and the combined average volume of the right and left alveolar cleft defects in bilateral cleft lip and palate was 0.82 cm(3). The average percentage bone fill in both unilateral cleft lip and palate and bilateral cleft lip and palate was 84%. The outcome of alveolar bone grafting was assessed in relation to (1) type of cleft, (2) size of preoperative cleft defect, (3) presence or absence of lateral incisor, (4) root development stage of the maxillary canine on the cleft side, (5) timing, and (6) surgeon. None of these parameters significantly influenced the radiographic outcome of alveolar bone grafting.
Secondary alveolar bone grafting of the cleft defect in our center was successful, based on radiographic outcome using cone beam computed tomography scans. Volume rendering using cone beam computed tomography and Amira software is a reproducible and practical method to assess the preoperative alveolar cleft volume and the adequacy of bone fill postoperatively.
使用锥形束计算机断层扫描评估非综合征性单侧或双侧唇腭裂患者二期牙槽骨植骨的影像学结果。
本前瞻性研究在加利福尼亚大学旧金山分校颅面畸形中心对21例年龄在8至12岁之间需要牙槽骨植骨的非综合征性完全性唇腭裂患者进行。17名单侧唇腭裂患者和4名双侧唇腭裂患者术前行锥形束计算机断层扫描，术后也进行扫描，并使用Amira 3.1.1软件进行分析。
单侧唇腭裂术前牙槽裂缺损的平均体积为0.61 cm³，双侧唇腭裂左右牙槽裂缺损的合并平均体积为0.82 cm³。单侧唇腭裂和双侧唇腭裂的平均骨填充百分比均为84%。根据以下因素评估牙槽骨植骨的结果：（1）腭裂类型，（2）术前腭裂缺损大小，（3）侧切牙的有无，（4）腭裂侧上颌尖牙的牙根发育阶段，（5）手术时机，（6）外科医生。这些参数均未对牙槽骨植骨的影像学结果产生显著影响。
基于锥形束计算机断层扫描的影像学结果，我们中心对腭裂缺损进行的二期牙槽骨植骨是成功的。使用锥形束计算机断层扫描和Amira软件进行容积再现是一种可重复且实用的方法，可用于评估术前牙槽裂体积和术后骨填充的充足程度。
