Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China.
Digital Simulation Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China.
J Craniomaxillofac Surg. 2020 Jul;48(7):632-637. doi: 10.1016/j.jcms.2020.02.015. Epub 2020 Mar 2.
An accurate volumetric analysis protocol for secondary alveolar cleft reconstruction is essential. It can help confirm favorable times for bone grafting, determine which graft material is more effective, and improve surgical techniques. This study aimed to introduce a novel protocol for precisely calculating the bone formation ratio (BF%) using computer-aided engineering. The helical computed tomography (CT) datasets of 14 patients who underwent alveolar cleft reconstruction was included in this study. CT scans performed preoperatively and 1 year postoperatively were evaluated by two investigators. Digital Imaging and Communications in Medicine (DICOM) data were reconstructed as three-dimensional (3D) images using Mimics software and processed by Geomagic Wrap (2017). Using the Boolean operation, the newly formed bone of the alveolar cleft was segmented by identifying the differences between pre- and postoperative 3D images. The volumetric assessment and morphological analysis of the newly formed bone could be determined in a precise manner, the mean BF% was 47.7% ± 16.4%, the mean time required for calculating was 23.57 ± 3.64 min. For the difference in the volume of newly formed bone between the two observers, the intraclass correlation coefficient (ICC) was 0.92, p < 0.001. This method is clinically practical and precise measurement, which has good reproducibility for evaluating outcome of different grafting materials for alveolar clefts.
准确的二次牙槽裂重建容积分析方案至关重要。它有助于确定植骨的有利时机，确定哪种移植材料更有效，并改进手术技术。本研究旨在介绍一种使用计算机辅助工程精确计算骨形成率（BF%）的新方案。该研究纳入了 14 例接受牙槽裂重建的患者的螺旋 CT（CT）数据集。由两名研究者评估术前和术后 1 年的 CT 扫描。使用 Mimics 软件将数字成像和通信医学（DICOM）数据重建为三维（3D）图像，并使用 Geomagic Wrap（2017）进行处理。通过布尔运算，通过识别术前和术后 3D 图像之间的差异，对牙槽裂新形成的骨进行分割。可以精确地确定新形成骨的体积评估和形态分析，平均 BF%为 47.7%±16.4%，计算所需的平均时间为 23.57±3.64 分钟。对于两位观察者之间新形成骨体积的差异，组内相关系数（ICC）为 0.92，p<0.001。该方法具有临床实用性和精确测量，对于评估不同牙槽裂移植材料的效果具有良好的可重复性。
