Bagnarosa Tony, Ferri Joël, Grégoire Gaspard, Baralle Marie-Madeleine, Drumez Elodie, Touzet-Roumazeille Sandrine
Univ. Lille, CHU Lille, Maxillofacial surgery and Stomatology department.
Univ. Lille, CHU Lille, INSERM, Maxillofacial Surgery and Stomatology department, U1008-Controlled Drug Delivery Systems and Biomaterials.
J Craniofac Surg. 2023;34(1):70-75. doi: 10.1097/SCS.0000000000008880. Epub 2022 Aug 11.
Reconstruction of alveolar clefts using cancellous bone graft is associated with a high rate of resorption. The aim of this study was to evaluate the osseointegration capacity of cortical calvarial bone grafting using 3-dimensional imaging assessment for alveolar cleft reconstruction in pediatric population.All alveolar bone grafting procedures performed between January 2015 and October 2017 in the maxillofacial surgery department of Lille University Hospital were included. All patients were evaluated clinically and by 3-dimensional imaging before bone grafting and at 3 months after surgery. Cleft and bone graft volumes were assessed using Horos software, v. 3.3.5, through a segmentation process. The bone filled ratio at 3 months after surgery was calculated. A total of 48 alveolar bone grafting procedures were performed in 37 patients: 3 unilateral cleft lip and alveolar, 20 unilateral cleft lip and palate, and 25 bilateral full cleft lip and palate (3 patients had only unilateral surgery). The mean bone filled ratio was 72.27%±23.65%, 81% for unilateral cleft lip and alveolus, 75.4%±20.6 for unilateral cleft lip and palate, and 65.5%±30 for bilateral complete cleft lip and palate ( P =0.1981). Calvarial bone grafting seems to be a relevant alternative to other donor sites for alveolar cleft reconstruction.
使用松质骨移植修复牙槽嵴裂会伴随较高的吸收速率。本研究的目的是通过三维成像评估，来评价小儿群体中采用颅骨皮质骨移植修复牙槽嵴裂的骨整合能力。纳入了2015年1月至2017年10月在里尔大学医院颌面外科进行的所有牙槽骨移植手术。所有患者在骨移植前及术后3个月均进行了临床评估和三维成像评估。使用Horos软件v. 3.3.5通过分割过程评估裂隙和骨移植的体积。计算术后3个月时的骨填充率。37例患者共进行了48次牙槽骨移植手术：3例单侧唇腭裂牙槽突裂，20例单侧唇腭裂，25例双侧完全性唇腭裂（3例患者仅接受了单侧手术）。平均骨填充率为72.27%±23.65%，单侧唇腭裂牙槽突裂为81%，单侧唇腭裂为75.4%±20.6，双侧完全性唇腭裂为65.5%±30（P = 0.1981）。颅骨皮质骨移植似乎是牙槽嵴裂修复中其他供区的一个合适替代方案。
