Zhou Wei-na, Xu Yan-bin, Jiang Hong-bing, Wan Linzhong, Du Yi-fei
*Jiangsu Key Laboratory of Oral Diseases †Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology ‡The Research Institute of Stomatology, The Second Clinical Department, School of Stomatology §The Research Institute of Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Nanjing Medical University, Nanjing, China.
J Craniofac Surg. 2015 Sep;26(6):e535-9. doi: 10.1097/SCS.0000000000002034.
The aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) to assess the volume of bone graft in alveolar cleft patients.
Twelve patients of unilateral alveolar cleft were included in this study. All patients were taken CBCT preoperative and 1 week postoperative. The digital imaging and communications in medicine (DICOM) files were imported into Simplant software and three-dimensional (3D) reconstruction of the alveolar defect was achieved. With 3D volumetric measurements module, the volume of alveolar cleft was calculated preoperatively. During operation, the syringe compression method was adopted to calculate the actual amount of bone graft. One week postoperative, CBCT scan was performed again to measure the bone volume grafted to the defect. The volumetric ratio of the syringe compression method to preoperative CBCT assessment and the volume difference between syringe compression method and postoperative CBCT assessment were analyzed to evaluate the accuracy of CBCT measurement.
The 3D structure of the alveolar cleft and the boundary of bone graft was clear from CBCT images. The estimated volume of alveolar cleft by preoperative CBCT scans was 1.06 ± 0.09 cm, and the actual amount of bone graft determined by the syringe compression method was 1.51 ± 0.12 cm. The ratio between the latter to the former was 1.43 ± 0.07. The calculated volume of bone graft by 1-week postoperative CBCT scans was 1.53 ± 0.11 cm, with no significant difference compared with the actual amount of bone graft (P > 0.05).
CBCT was an accurate measurement to calculate the volume of alveolar defect and bone graft in alveolar cleft patients. Preoperative scans could aid in quantitatively determining the bone amount needed to adequately fill the bone defect, and the postoperative scans give accurate follow-up evaluation after surgery.
本研究旨在探讨锥形束计算机断层扫描(CBCT)评估牙槽嵴裂患者骨移植体积的准确性。
本研究纳入12例单侧牙槽嵴裂患者。所有患者在术前及术后1周均接受CBCT检查。将医学数字成像和通信(DICOM)文件导入Simplant软件,实现牙槽骨缺损的三维(3D)重建。利用3D体积测量模块,术前计算牙槽嵴裂的体积。手术过程中,采用注射器挤压法计算实际骨移植量。术后1周,再次进行CBCT扫描,测量移植到缺损处的骨体积。分析注射器挤压法与术前CBCT评估的体积比以及注射器挤压法与术后CBCT评估的体积差异,以评估CBCT测量的准确性。
CBCT图像上牙槽嵴裂的三维结构及骨移植边界清晰。术前CBCT扫描估计牙槽嵴裂体积为1.06±0.09cm,注射器挤压法确定的实际骨移植量为1.51±0.12cm。后者与前者的比值为1.43±0.07。术后1周CBCT扫描计算的骨移植体积为1.53±0.11cm,与实际骨移植量相比无显著差异(P>0.05)。
CBCT是计算牙槽嵴裂患者牙槽骨缺损和骨移植体积的准确测量方法。术前扫描有助于定量确定充分填充骨缺损所需的骨量,术后扫描可在术后进行准确的随访评估。