Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Institute of Medical Biometry, University Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Int J Implant Dent. 2023 Sep 5;9(1):26. doi: 10.1186/s40729-023-00492-0.
Bone augmentation procedures are established tools for reshaping the alveolar ridge and increasing bone volume. Different approaches are being used to measure postoperative bone volume gain. This study aimed to develop an objective and automated volume measurement tool equally as precise as manual slice-by-slice annotation.
To evaluate the proposed workflow, we performed an in vitro study with 20 pig mandibles that were grafted using three different grafting techniques-autogenous full block, split block bone and shell augmentation. The pig jaws were scanned pre- and postoperatively using an intraoral scanner. The resulting surface files (baseline, full block, split block, shell) were processed using the new volume-measuring workflow as well as using manual slice-by-slice annotation at baseline (t0) and at 6 months (t1) using the same population. Two TOSTs (Test of One-Sided Significance) and NHSTs (Null Hypothesis Significance Test) were used to compare the two workflows. The intra-rater reliability between t0 and t1 was determined using intraclass correlation coefficients.
The mean difference for the full block augmentation technique was - 0.015 cm (p < 0.001); for the split block technique, it was - 0.034 cm p = 0.01, and for the shell technique, it was - 0.042 cm. All results were statistically not different from zero and statistically equivalent to zero. The results also showed an excellent absolute intra-rater agreement.
The semiautomatic volume measurement established in this article achieves comparable results to manual slice-by-slice measuring in determining volumes on STL files generated by intraoral scanners and shows an excellent intra-rater reliability.
骨增量手术是重塑牙槽嵴和增加骨量的成熟工具。目前有多种方法用于测量术后骨量增加。本研究旨在开发一种客观、自动的体积测量工具,其精确性与手动逐层标注相当。
为了评估所提出的工作流程,我们进行了一项体外研究,使用三种不同的移植技术——自体整块、块状骨劈开和骨壳增强,对 20 个猪下颌进行了移植。猪下颌在术前和术后使用口腔内扫描仪进行扫描。使用新的体积测量工作流程以及使用相同人群在基线(t0)和 6 个月(t1)时进行的手动逐层标注,对产生的表面文件(基线、整块、块状骨劈开、骨壳)进行处理。使用单侧检验(Test of One-Sided Significance,TOST)和零假设检验(Null Hypothesis Significance Test,NHST)对两种工作流程进行比较。使用组内相关系数(intraclass correlation coefficients)确定 t0 和 t1 之间的组内可靠性。
整块增强技术的平均差值为 -0.015cm(p<0.001);块状骨劈开技术的差值为 -0.034cm(p=0.01);骨壳技术的差值为 -0.042cm。所有结果均与零值在统计学上无差异,且在统计学上等效于零值。结果还显示出极好的绝对组内一致性。
本文建立的半自动体积测量方法在确定口腔内扫描仪生成的 STL 文件的体积方面,与手动逐层测量方法具有相当的结果,并显示出极好的组内可靠性。