Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Hangzhou, Zhejiang 310000, China.
Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, Fujian 350001, China; Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, No. 88 Jiaotong Road, Fuzhou, Fujian 350002, China.
J Stomatol Oral Maxillofac Surg. 2024 Sep;125(5S1):101896. doi: 10.1016/j.jormas.2024.101896. Epub 2024 Apr 27.
In this study, we aimed to provide guidance for selecting bone grafting materials in cases of alveolar clefts. Twenty-nine patients with unilateral complete alveolar clefts were categorized into three groups based on the bone grafting material used: Group A (iliac bone block grafts), Group B (iliac cancellous bone grafts), and Group C (chin bone block grafts). Cone-beam computed tomography (CBCT) data were analyzed using Mimics 19.0 software. Results showed that Group A had the highest bone formation rate, with significant differences observed between Groups A and B, as well as between Groups B and C. Group A and Group C had the highest proportion of Type I in volume assessment, while Group B had the highest proportion of Type III, Significant differences were observed in the distribution of volume assessment scores among the three groups. Bone height measurement results indicated that buccal-side measurement points had a higher proportion of Type I bone height than palatal-side measurement points. Bone width measurement results showed that Type I bone width was highest in Group C, while Type IV bone width was highest in Group B. Significant differences were observed in the distribution of implanted bone width among the three groups. Total grafting scores indicated that Types A and D were predominant in Groups A and C, while Group B had the highest proportion of Type D. Significant differences were observed in the distribution of total grafting scores among the three groups. The comprehensive evaluation method provides accurate assessment of alveolar cleft bone grafting outcomes and is applicable in clinical settings. Based on the results, we consider both iliac bone blocks and chin bone blocks as suitable materials for alveolar cleft bone grafting. Grafting material selection should consider preoperative gap volume measured using CBCT, required bone quantity, donor site complications, and overall clinical needs.
在这项研究中,我们旨在为牙槽裂患者选择骨移植材料提供指导。根据使用的骨移植材料,将 29 例单侧完全性牙槽裂患者分为三组:A 组(髂骨块移植)、B 组(髂骨松质骨移植)和 C 组(颏骨块移植)。使用 Mimics 19.0 软件对锥形束 CT(CBCT)数据进行分析。结果显示,A 组成骨率最高,A 组与 B 组、B 组与 C 组之间存在显著差异。A 组和 C 组在体积评估中Ⅰ型比例最高,而 B 组在Ⅲ型比例最高,三组之间体积评估评分的分布存在显著差异。骨高度测量结果表明,颊侧测量点的Ⅰ型骨高度比例高于腭侧测量点。骨宽度测量结果显示,C 组Ⅰ型骨宽度最高,B 组Ⅳ型骨宽度最高。三组之间植入骨宽度的分布存在显著差异。总移植评分表明,A 组和 C 组以 A 型和 D 型为主,B 组以 D 型为主。三组之间总移植评分的分布存在显著差异。综合评价方法能准确评估牙槽裂骨移植的效果,适用于临床。基于这些结果,我们认为髂骨块和颏骨块均可作为牙槽裂骨移植的合适材料。选择移植材料时应考虑术前使用 CBCT 测量的间隙体积、所需骨量、供区并发症以及整体临床需求。