Chen Pin-Ru, Lin Yu-Ching, Pai Betty Chien-Jung, Tseng Hsiao-Jung, Lo Lun-Jou, Chou Pang-Yun
Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 33302, Taiwan.
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
J Clin Med. 2021 Nov 1;10(21):5143. doi: 10.3390/jcm10215143.
(1) Background: Continuing to observe the grafted bone mineral density (BMD) is essential to ensure the success of alveolar bone grafting (ABG) in patients with cleft lip and palate. This study elaborates on three methods that can be used to evaluate the progressive BMD. (2) Methods: Forty patients with unilateral or bilateral clefts receiving ABG were enrolled. Cone beam computed tomography (CBCT) scans were taken at 6 months (T1) and 2 years (T2) postoperatively. In CBCT, measurements were obtained on three different planes using the circle located 1 mm from the adjacent teeth (Method A), the largest circle within the defect (Method B), or the central circle with a diameter of 2 mm (Method C). The BMD was the average density of the three planes and was adjusted by pogonion density. Bland-Altman plots were used to evaluate the agreement of each method. Inter-rater reliability was confirmed by the intraclass correlation coefficient (ICC). (3) Results: For Method A, B, and C, the mean-adjusted BMD (BMD/pogonion density, BMD) was 17.44%, 17.88%, and 17.69%, respectively, at T1 ( = 0.495), and 22.51%, 22.87%, and 22.74%, respectively, at T2 ( = 0.690); the density enhancement rates were 40.54%, 38.92%, and 43.15% ( = 0.382). Significant differences between the BMD at T1 and T2 were observed ( < 0.001, <0.001, and 0.001, for Method A, B, and C, respectively). The volume of the grafted tissue remained stable during T1 and T2, and no significant correlation between density enhancement rate and volume loss was observed. (4) Conclusions: A significant increase in the BMD of grafted tissue was observed in the 2-year postoperative follow-up. The three methods for measuring BMD via CBCT can be applied in post-ABG evaluations.
(1) 背景：持续观察移植骨的骨密度（BMD）对于确保唇腭裂患者牙槽骨移植（ABG）的成功至关重要。本研究详细阐述了三种可用于评估渐进性骨密度的方法。(2) 方法：纳入40例接受ABG的单侧或双侧腭裂患者。术后6个月（T1）和2年（T2）进行锥形束计算机断层扫描（CBCT）。在CBCT中，使用距相邻牙齿1mm的圆圈（方法A）、缺损内最大的圆圈（方法B）或直径为2mm的中心圆圈（方法C）在三个不同平面上进行测量。骨密度是三个平面的平均密度，并通过鼻下点密度进行调整。采用Bland-Altman图评估每种方法的一致性。组内相关系数（ICC）确定了评分者间的可靠性。(3) 结果：对于方法A、B和C，T1时平均调整骨密度（骨密度/鼻下点密度，BMD）分别为17.44%、17.88%和17.69%（ = 0.495），T2时分别为22.51%、22.87%和22.74%（ = 0.690）；密度增强率分别为40.54%、38.92%和43.15%（ = 0.382）。观察到T1和T2时骨密度存在显著差异（方法A、B和C分别为 < 0.001、<0.001和0.001）。移植组织的体积在T1和T2期间保持稳定，且未观察到密度增强率与体积损失之间存在显著相关性。(4) 结论：术后2年随访观察到移植组织的骨密度显著增加。通过CBCT测量骨密度的三种方法可应用于ABG术后评估。
