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锥形束计算机断层扫描在单侧唇腭裂儿童牙槽骨植骨评估中的应用

Cone beam computed tomography in the assessment of alveolar bone grafting in children with unilateral cleft lip and palate.

作者信息

Suomalainen Anni, Åberg Thomas, Rautio Jorma, Hurmerinta Kirsti

机构信息

*Department of Radiology, Helsinki University Central Hospital and University of Helsinki,

**Department of Orthodontics, Institute of Dentistry, University of Helsinki.

出版信息

Eur J Orthod. 2014 Oct;36(5):603-11. doi: 10.1093/ejo/cjt105. Epub 2014 Feb 7.

Abstract

OBJECTIVES

To quantify the treatment outcome of secondary alveolar bone grafting (SABG) in individuals with unilateral cleft lip and palate using cone beam computed tomography (CBCT) and to reveal needs for improvement in surgical technique.

MATERIAL AND METHODS

CBCT images taken 6 months after SABG of 35 patients were analysed. Vertical and horizontal bone supports of the grafted bone at three levels of the roots of the adjacent teeth were classified, the height of the nasal floor was compared with the unaffected side, and the inter- and intraexaminer reproducibility of these evaluations was assessed.

RESULTS

The grafted bone filled the defect in all three vertical measurement levels in 34 per cent. The labiopalatal thickness of the grafted bone was good in at least one-third of the root length in 66 per cent and fair in 34 per cent. Typically, the bone graft was deficient in the apical and palatal direction. Clear asymmetry in the nasal floor was found in 72 per cent. Kappa values indicated excellent agreement for all but one measured parameter.

LIMITATIONS

This is a preliminary study involving only a limited number of study subjects.

CONCLUSIONS

Our results showed mainly a good or fair treatment outcome. Deficiency of the bone graft was observed mostly in the apical and palatal areas of the defect. Asymmetry of the nasal floor was observed frequently. Careful insertion of the bone graft towards the palatal and apical direction of the cleft is recommended.

摘要

目的

使用锥形束计算机断层扫描(CBCT)对单侧唇腭裂患者二期牙槽骨植骨术(SABG)的治疗效果进行量化,并揭示手术技术需要改进之处。

材料与方法

分析35例患者SABG术后6个月的CBCT图像。对相邻牙齿牙根三个水平处移植骨的垂直和水平骨支撑进行分类,将鼻底高度与未受影响侧进行比较,并评估这些评估在检查者之间和检查者内部的可重复性。

结果

34%的患者移植骨在所有三个垂直测量水平上均填充了缺损。66%的患者移植骨的唇腭厚度在至少三分之一的牙根长度上良好,34%的患者为中等。通常,移植骨在根尖和腭侧方向不足。72%的患者鼻底存在明显不对称。除一个测量参数外,kappa值表明所有测量参数的一致性极佳。

局限性

这是一项仅涉及有限数量研究对象的初步研究。

结论

我们的结果显示治疗效果主要良好或中等。移植骨的不足主要见于缺损的根尖和腭侧区域。鼻底不对称较为常见。建议在腭裂的腭侧和根尖方向小心植入移植骨。

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