Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Craniofac Surg. 2023 May 1;34(3):e289-e293. doi: 10.1097/SCS.0000000000009209. Epub 2023 Mar 13.
A large number of older patients (≥13 y old) with alveolar clefts missed the optimal alveolar bone grafting time period in China. This study aimed to determine the accuracy and repeatability of modified computer-aided engineering subtraction for volumetric measurement of these patients. In addition, the study aimed to determine whether the volume of defect is correlated with cleft type (cleft lip and alveolus, cleft lip and palate), cleft location, age, and sex. Preoperative computed tomography data from 100 patients of unilateral alveolar cleft patients without secondary alveolar bone grafting were measured using 2 methods. The maxillary resin model around the alveolar cleft was printed using the 3-dimensional (D) printing method, and the volume of the defect was measured using the drainage method. In the modified subtraction method, Mimics software was used to simulate fracture filling by layer drawing, and the defect volume was determined by subtracting the preoperative fracture template from the filled 3D skull template. The mean time taken to calculate an alveolar cleft defect volume by modified subtraction method was 3.2 minutes. The average defect volume measured using the 3D printing and modified subtraction methods were 1.58±0.41 and 1.55±0.42 cm 3 , respectively. Findings suggest that cleft location and age do not affect the defect volume of older patients with alveolar cleft, unlike cleft type and sex. The modified computer-aided subtraction method provides good accuracy, consistency, and reproducibility in measuring alveolar ridge defect volume. Moreover, this method is more efficient and cost-effective than the 3D-printed model method.
大量中国的大龄（≥13 岁）牙槽裂患者错过了最佳牙槽骨移植时间。本研究旨在确定改良计算机辅助工程减法对这些患者容积测量的准确性和可重复性。此外，本研究旨在确定缺陷体积是否与裂隙类型（唇裂和牙槽裂、唇裂和腭裂）、裂隙位置、年龄和性别相关。使用 2 种方法测量了 100 例单侧牙槽裂患者的术前 CT 数据，这些患者未进行二次牙槽骨移植。使用 3D 打印方法打印牙槽裂周围的上颌树脂模型，并使用排水法测量缺损体积。在改良减法中，使用 Mimics 软件通过分层绘制模拟骨折填充，并通过从填充的 3D 颅骨模板中减去术前骨折模板来确定缺陷体积。改良减法计算牙槽裂缺陷体积的平均时间为 3.2 分钟。3D 打印和改良减法测量的平均缺陷体积分别为 1.58±0.41 和 1.55±0.42cm3。结果表明，与性别不同，裂隙位置和年龄并不影响大龄牙槽裂患者的缺陷体积，而裂隙类型则影响缺陷体积。改良计算机辅助减法在测量牙槽嵴缺损体积方面具有良好的准确性、一致性和可重复性。此外，该方法比 3D 打印模型方法更高效、更经济。
