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一种用于评估唇腭裂患者牙槽骨移植的新方法:锥形束 CT 评估。

A novel method for alveolar bone grafting assessment in cleft lip and palate patients: cone-beam computed tomography evaluation.

机构信息

Department of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210, Gdańsk, Poland.

出版信息

Clin Oral Investig. 2021 Apr;25(4):1967-1975. doi: 10.1007/s00784-020-03505-z. Epub 2020 Aug 15.

Abstract

OBJECTIVES

This retrospective cross-sectional study aimed to present a new method for secondary alveolar bone grafting (SABG) assessment and to qualitatively evaluate the SABG results in unilateral cleft lip and palate patients.

MATERIALS AND METHODS

Research was conducted according to the STROBE guidelines. The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography (CBCT) was performed at least 1 year after grafting. The experimental side was the cleft side, and the contralateral side without a congenital cleft was the control. Measurements were performed at four levels of the maxillary central incisors' roots according to the new scale with scores from 0 to 3. The sum of the scores provided a general assessment of bone architecture. The Wilcoxon signed-rank test was used for intergroup comparisons, and a Kappa coefficient was used for reproducibility measurements.

RESULTS

High individual variability was found, and the bone architecture was significantly worse on the cleft side than on the noncleft side. The results showed 28.57% failure, 33.33% poor, 19.05% moderate, and 19.05% good results from the surgical procedure. Kappa coefficients produced results from 0.92 to 1.00 for intra-rater and from 0.81 to 1.00 for inter-rater reproducibility.

CONCLUSIONS

CBCT provides detailed information about alveolar bone morphology. The new assessment method is useful at every treatment stage and provides excellent repeatability. SABG did not provide good bone morphology, in most cases.

CLINICAL RELEVANCE

This research presents a new universal alternative for the assessment of SABG by utilizing CBCT.

摘要

目的

本回顾性横断面研究旨在提出一种新的牙槽二次骨移植(SABG)评估方法,并定性评估单侧唇腭裂患者的 SABG 结果。

材料与方法

研究遵循 STROBE 指南进行。研究组包括 21 名平均年龄为 16 岁的患者。在移植后至少 1 年进行高分辨率锥形束 CT(CBCT)检查。实验组为裂隙侧,对侧无先天性裂隙的侧为对照组。根据新的评分系统,在每颗上颌中切牙牙根的四个水平上进行测量,评分范围为 0 至 3 分。评分总和提供了骨结构的总体评估。采用 Wilcoxon 符号秩检验进行组间比较,采用 Kappa 系数进行可重复性测量。

结果

发现个体间存在高度变异性,且裂隙侧的骨结构明显劣于非裂隙侧。结果显示手术程序的失败率为 28.57%,较差为 33.33%,中等为 19.05%,良好为 19.05%。内部观察者的 Kappa 系数为 0.92 至 1.00,外部观察者的 Kappa 系数为 0.81 至 1.00。

结论

CBCT 提供了牙槽骨形态的详细信息。新的评估方法在每个治疗阶段都很有用,具有极好的可重复性。SABG 并未提供良好的骨形态,在大多数情况下。

临床意义

本研究提出了一种利用 CBCT 评估 SABG 的新的通用替代方法。

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