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通过两种图像匹配工具测量定制同种异体骨块的体积变化:一种用于评估移植物吸收的新型评估技术介绍

Volumetric Changes of a Customized Allogeneic Bone Block Measured by Two Image Matching Tools: Introduction of a Novel Assessment Technique for Graft Resorption.

作者信息

Blume Oliver, Donkiewicz Phil, Palkovics Daniel, Götz Werner, Windisch Péter

机构信息

Private Practice 'Dres. Back & Blume', Tal 13, 80331 Munich, Germany.

Department of Oral Surgery and Dental Emergency Care, Faculty of Health, School of Dentistry, Witten / Herdecke University, North RhineWestphalia, Germany.

出版信息

Acta Stomatol Croat. 2021 Dec;55(4):406-417. doi: 10.15644/asc55/4/8.

Abstract

OBJECTIVE

The purpose of this case report was to present a method for the assessment of volumetric changes of bone blocks during healing and demonstrate its practicability by analysing the resorption of a pre-shaped allogeneic bone block used for the reconstruction of a complex maxillary defect.

MATERIALS AND METHODS

CBCT-scans of a 19-year-old male treated with an allogeneic bone block were recorded pre-OP, post-OP, and following six months of healing. Graft shrinkage was assessed via two image matching tools, namely coDiagnostiX® and Slicer. A biopsy specimen was harvested along the implant canal at the time of implantation.

RESULTS

The osseous defect was successfully restored and advanced graft remodelling was found upon re-entry as confirmed by the histomorphometric and histologic analysis. The initial volumes of the graft determined via coDiagnostiX® and Slicer were 0.373 mL and 0.370 mL., respectively, while graft resorption after six months of healing was 0.011 mL (3.00%) and 0.016 mL (4.33%).

CONCLUSIONS

The avoidance of bone harvesting and reduction of invasiveness display an important issue in dentoalveolar restorations. However, before grafting materials can be considered a safe alternative, understanding their clinical performance, especially resorption stability, is pivotal. The present case report demonstrates a limited resorption of the allogeneic bone block and further emphasizes the practicability of determining bone resorption by the here introduced method. As our investigation comprises solely one subject, the results should be considered with care and substantiated by further studies.

摘要

目的

本病例报告旨在介绍一种评估骨块愈合过程中体积变化的方法,并通过分析用于复杂上颌骨缺损重建的预成型同种异体骨块的吸收情况来证明其实用性。

材料与方法

对一名接受同种异体骨块治疗的19岁男性患者在术前、术后及愈合6个月后进行CBCT扫描。通过两种图像匹配工具coDiagnostiX®和Slicer评估移植物收缩情况。在植入时沿种植体通道采集活检标本。

结果

骨缺损成功修复,再次切开时发现移植物有明显的重塑,组织形态计量学和组织学分析证实了这一点。通过coDiagnostiX®和Slicer测定的移植物初始体积分别为0.373 mL和0.370 mL,而愈合6个月后的移植物吸收量分别为0.011 mL(3.00%)和0.016 mL(4.33%)。

结论

避免取骨和减少侵袭性是牙牙槽修复中的一个重要问题。然而,在将移植材料视为安全替代物之前,了解其临床性能,尤其是吸收稳定性,至关重要。本病例报告显示同种异体骨块吸收有限,并进一步强调了通过本文介绍的方法确定骨吸收的实用性。由于我们的研究仅包含一名受试者,结果应谨慎考虑,并需进一步研究加以证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0396/8734454/61eb05575662/ASC_55(4)_406-417-f1.jpg

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