Etemadi Sh Milad, Movahedian Attar Bijan, Mehdizadeh Mojdeh, Tajmiri Golnaz
Department of Oral and Maxillofacial Surgery, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Oral and Maxillofacial Surgery, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Oral and Maxillofacial Radiology, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e1-e5. doi: 10.1016/j.jormas.2021.06.006. Epub 2021 Jun 24.
Appropriate radiographic evaluation is a fundamental step for determining the topography of the defect before the surgical intervention for alveolar bone grafting. Evaluation of cleft volume by CBCT has been done in dry skull samples in previous studies and it was recommended as an effective tool in the volumetric evaluation of the bone defect prior to the surgery. The purpose of this study was to evaluate the accuracy of preoperative clinical use of CBCT imaging in determining the alveolar cleft volume.
We performed a clinical study. 20 patients with unilateral alveolar cleft underwent preoperative radiographic evaluation using CBCT scan. Volumetric measurement was performed by an oral and maxillofacial radiologist using 0.5, 1, and 2 mm slices and an oral and maxillofacial surgeon using 2 mm slices. After the closure of the nasal floor and palatal mucosa, the alveolar defect was clinically measured with putty impression material. Descriptive and bivariate statistics were computed and the p-value was set at 0.05.
This study showed that there is a statistically significant difference between CBCT-estimated and clinical volumes of the alveolar cleft (paired T-test, p-value < 0.05).
Considering the significant difference between clinical and CBCT-estimated volumes of the alveolar cleft, CBCT imaging is not considered an accurate tool for pre-operative volumetric assessment of the alveolar cleft.
在进行牙槽骨移植手术干预之前，进行适当的影像学评估是确定缺损形态的基本步骤。此前的研究已在干燥颅骨样本中通过CBCT对腭裂体积进行了评估，并且推荐将其作为术前骨缺损体积评估的有效工具。本研究的目的是评估术前临床使用CBCT成像确定牙槽裂体积的准确性。
我们开展了一项临床研究。20名单侧牙槽裂患者接受了术前CBCT扫描影像学评估。由一名口腔颌面放射科医生使用0.5毫米、1毫米和2毫米层厚进行体积测量，一名口腔颌面外科医生使用2毫米层厚进行测量。在封闭鼻底和腭黏膜后，使用油灰印模材料对牙槽缺损进行临床测量。计算描述性和双变量统计数据，p值设定为0.05。
本研究表明，CBCT估计的牙槽裂体积与临床测量体积之间存在统计学显著差异（配对t检验，p值<0.05）。
考虑到牙槽裂临床体积与CBCT估计体积之间存在显著差异，CBCT成像不被认为是术前牙槽裂体积评估的准确工具。
