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使用多层螺旋计算机断层扫描和三维打印模型评估腭裂患者二期牙槽骨移植的长期稳定性:一项前瞻性研究。

Evaluation of Long-term Stability of Secondary Alveolar Bone Grafts in Cleft Palate Patients Using Multislice Computed Tomography and Three-Dimensional Printed Models: A Prospective Study.

作者信息

Palankar Venkatesh, Sattur Atul, Palankar Aditi, Rajeswari S Raja, Thakur Srinath, Desai Anil Kumar

机构信息

Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

出版信息

J Pharm Bioallied Sci. 2021 Nov;13(Suppl 2):S1496-S1500. doi: 10.4103/jpbs.jpbs_265_21. Epub 2021 Nov 10.

Abstract

AIM

Three-dimensional (3D) printed models are contemporary volumetric bone graft assessment technique for secondary alveolar bone grafting (SABG) in cleft lip and palate (CLP) patients. The study aimed at evaluation of long-term stability of iliac autograft in SABG using multislice computed tomography (CT) and 3D-printed model-based volumetric analysis.

MATERIALS AND METHODS

Twenty-eight patients were included in this prospective clinical study. CT image (T1) was taken after orthodontic maxillary expansion, correlating with the presurgical image. Furthermore, 3D-printed model was prepared, and volumetric assessment of graft needed was ascertained with water displacement technique. SABG was carried on with the anterior iliac crest autografting procedure. After 1-year follow-up, postoperative CT analysis (T2) was followed upon.

RESULTS

The stability of bone graft at the 1-year postoperative was found to be 43.74% with mean bone loss of 56.26% (95% confidence interval; < 0.005). The moderate scale of CLP cases has shown statistically significant bone stability compared to that of severe and mild cases. Furthermore, the 3D-printed model has shown a significant difference to that of T1 CT imaging ( < 0.005).

CONCLUSION

Within the limitations of the study, it seems appropriate to conclude that 3D-printed models serves as better reference than CT imaging in the context of planning and execution of precise bone grafting in SABG.

摘要

目的

三维(3D)打印模型是唇腭裂(CLP)患者二期牙槽骨植骨(SABG)的当代容积性骨移植评估技术。本研究旨在使用多层计算机断层扫描(CT)和基于3D打印模型的容积分析评估SABG中髂骨自体骨移植的长期稳定性。

材料与方法

本前瞻性临床研究纳入28例患者。正畸上颌扩弓后拍摄CT图像(T1),与术前图像进行对比。此外,制备3D打印模型,并采用排水法确定所需移植骨的容积评估。采用髂前嵴自体骨移植术进行SABG。1年随访后,进行术后CT分析(T2)。

结果

术后1年骨移植的稳定性为43.74%,平均骨丢失率为56.26%(95%置信区间;<0.005)。与重度和轻度唇腭裂病例相比,中度唇腭裂病例的骨稳定性具有统计学意义。此外,3D打印模型与T1 CT成像显示出显著差异(<0.005)。

结论

在本研究的局限性范围内,可以得出结论,在SABG精确骨移植的规划和实施方面,3D打印模型比CT成像更适合作为参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8f/8687034/c734c69bef58/JPBS-13-1496-g001.jpg

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