Garib Daniela, Massaro Camila, Yatabe Marilia, Janson Guilherme, Lauris José Roberto P
Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2017 May;151(5):869-877. doi: 10.1016/j.ajodo.2016.11.019.
The aims of this study were to qualitatively assess the mesial and distal alveolar bone of maxillary canines mesially moved to replace absent lateral incisors in patients with unilateral cleft lip and palate after secondary alveolar bone graft and to assess the reproducibility of the proposed cone-beam computed tomography (CBCT) method.
The sample comprised CBCT examinations of 30 patients with unilateral cleft lip and palate from 1 center. CBCT images were taken at least 6 months after comprehensive orthodontic treatment. The noncleft side was used as the control group. Using axial sections, scores from 0 to 4 (bone absence to complete bone filling, respectively) were given to the mesial and distal alveolar bones of the maxillary canines. Interexaminer and intraexaminer reproducibility was assessed using kappa statistics. Intergroup comparisons were performed using Wilcoxon tests.
Interexaminer and intraexaminer agreement was excellent. Intergroup comparison identified smaller scores at the cervical and middle root levels of the cleft side mesial alveolar bone of the maxillary canines. At the cleft side, 85 mesial sites showed favorable scores (3 or 4); 1 had a score of 1, and 4 had scores of 2. At the distal surface, 78 sites were evaluated, and only 1 site received a score of 1. The noncleft side had scores of 4 for all sites.
The new CBCT scale showed good reproducibility. CBCT axial sections are reliable for a qualitative appraisal of alveolar bone in a grafted alveolar cleft. Mesial bone defects can be observed in maxillary canines moved into grafted areas after comprehensive orthodontic treatment, especially at the cervical root half.
本研究的目的是定性评估单侧唇腭裂患者在二期牙槽骨植骨后，将上颌尖牙近中移动以替代缺失侧切牙时，上颌尖牙近中及远中牙槽骨的情况，并评估所提出的锥形束计算机断层扫描（CBCT）方法的可重复性。
样本包括来自1个中心的30例单侧唇腭裂患者的CBCT检查。CBCT图像在综合正畸治疗至少6个月后拍摄。非腭裂侧作为对照组。使用轴向截面，对上颌尖牙的近中及远中牙槽骨给予0至4分（分别表示骨缺失至完全骨填充）。使用kappa统计量评估检查者间和检查者内的可重复性。组间比较采用Wilcoxon检验。
检查者间和检查者内的一致性极佳。组间比较发现，上颌尖牙腭裂侧近中牙槽骨的颈部和牙根中部水平得分较低。在腭裂侧，85个近中部位得分良好（3分或4分）；1个部位得1分，4个部位得2分。在远中面，评估了78个部位，只有1个部位得1分。非腭裂侧所有部位均得4分。
新的CBCT量表显示出良好的可重复性。CBCT轴向截面对于定性评估植骨牙槽裂中的牙槽骨是可靠的。在综合正畸治疗后，移入植骨区的上颌尖牙可观察到近中骨缺损情况，尤其是在牙根颈部一半处。
