Quereshy Fasial A, Barnum Geoffrey, Demko Catherine, Horan Michael, Palomo J Martin, Baur Dale A, Jannuzzi Jeremy
Department of Oral and Maxillofacial Surgery, Case Western Reserve University School of Dental Medicine, Cleveland, OH 44106, USA.
J Oral Maxillofac Surg. 2012 Jan;70(1):188-91. doi: 10.1016/j.joms.2011.01.027. Epub 2011 May 6.
The purpose of this study was to determine the utility of cone beam computed tomographic (CBCT) imaging in assessing the volume of alveolar cleft defects in patients undergoing secondary cleft repair.
Fourteen patients with unilateral clefts were analyzed in a retrospective study. Preoperative CBCT imaging of patients preparing to undergo secondary repair of alveolar clefts was reviewed. Using anatomic landmarks, 3 measurements were collected from CBCT images for each patient: facial width (FW), facial height (FH), and facial-palatal length (FL). These values were used to calculate the estimated volume (EV) of the cleft and thus the amount of bone graft material that would be needed to fill the defect.
The overall mean values of FW, FH, and FL were 9.7 ± 3.1, 14.07 ± 2.7, and 5.6 ± 0.8 mm, respectively. Mean EV was 489.0 ± 151.6 mm(3). The single (0.879) and average (0.956) measurements of the intraclass correlation coefficient for FH were very good to excellent. Similar data were observed for FH (single, 0.827; average, 0.935). For FL, a decreasing trend in the mean and variability over the 3 measurement times was reflected in low single (0.305) and moderate average (0.569) intraclass correlation coefficients.
CBCT imaging can be used to reliably measure FW, FH, and FL and to calculate the EV of the cleft. These data can be used by oral and maxillofacial surgeons to quantitatively assess the volume of an alveolar cleft and aid in preoperative determination of the amount of bone that will be needed to adequately graft the cleft space. This will also aid in appropriate selection of an autogenous graft donor site before surgery.
本研究的目的是确定锥形束计算机断层扫描（CBCT）成像在评估接受二期腭裂修复患者牙槽嵴裂缺损体积方面的效用。
在一项回顾性研究中分析了14例单侧腭裂患者。回顾了准备接受牙槽嵴裂二期修复患者的术前CBCT成像。利用解剖标志，从每位患者的CBCT图像中收集3项测量值：面部宽度（FW）、面部高度（FH）和面部-腭部长度（FL）。这些值用于计算腭裂的估计体积（EV），从而计算填充缺损所需的骨移植材料量。
FW、FH和FL的总体平均值分别为9.7±3.1、14.07±2.7和5.6±0.8mm。平均EV为489.0±151.6mm³。FH的组内相关系数的单次测量值（0.879）和平均值（0.956）非常好至优秀。FH也观察到类似数据（单次测量值，0.827；平均值，0.935）。对于FL，在3次测量时间内平均值和变异性的下降趋势反映在较低的单次测量值组内相关系数（0.305）和中等的平均值组内相关系数（0.569）上。
CBCT成像可用于可靠地测量FW、FH和FL，并计算腭裂的EV。口腔颌面外科医生可利用这些数据定量评估牙槽嵴裂的体积，并有助于术前确定充分植骨填充腭裂间隙所需的骨量。这也将有助于在手术前适当选择自体骨移植供区。
