Rosenstein S W, Long R E, Dado D V, Vinson B, Alder M E
Children's Memorial Hospital, Chicago, Illinois, USA.
Cleft Palate Craniofac J. 1997 May;34(3):199-205. doi: 10.1597/1545-1569_1997_034_0199_codcfp_2.3.co_2.
This investigation was conducted to determine the agreement between three-dimensional (3-D) calculations from CAT scans and two-dimensional (2-D) calculations from standard dental radiographs in evaluating bone support for cleft-adjacent teeth after primary bone grafting.
This retrospective study utilized CAT scans and dental radiographs taken of the alveolar cleft in patients an average of 11 years after primary bone grafting.
The subjects were patients treated by the Cleft Palate Team at Children's Memorial Hospital and Loyola University Medical Center, Chicago, Illinois.
Fourteen UCLP patients (9 males, 5 females) agreed to participate in this study by undergoing CAT scan assessment of their alveolar cleft sites. They also had to have periapical or occlusal radiographs of the grafted cleft site taken within 6 months of the CAT scan.
All patients underwent primary lip repair, placement of a passive palatal plate, primary alveolar bone grafting (mean age 6.4 months), and palatoplasty before 1 year of age. Major tooth movement through final orthodontics was completed by the time of the radiographic assessment.
CAT scan sections were reformatted and reconstructed to three-dimensionally calculate the percentage of root covered by bone support for the 15 teeth adjacent to the graft cleft sites. Dental radiographs of the same teeth were also traced and digitized. Percentages of root supported by bone were also established using the dental radiographs by dividing the amount of root covered by bone, by the anatomic root length.
A paired, two-sample t test revealed no significant differences between the two methods of assessment, while linear regression showed a statistically significant correlation between the CAT scan assessment and the percentages found on the radiographs.
Routine dental radiographs were able to estimate the total 3-D bone support for the roots of cleft adjacent teeth as determined by CAT scan to a statistically significant degree when groups where compared. The clinical significance for evaluation of individual cases was less impressive with a wide range of variability and a level of agreement that required acceptance of differences up to 25%.
本研究旨在确定在评估一期骨移植后腭裂相邻牙齿的骨支持情况时，计算机断层扫描（CAT）的三维（3-D）计算结果与标准牙科X线片的二维（2-D）计算结果之间的一致性。
这项回顾性研究利用了平均在一期骨移植后11年拍摄的患者牙槽裂的CAT扫描和牙科X线片。
研究对象为伊利诺伊州芝加哥市儿童纪念医院和洛约拉大学医学中心腭裂治疗团队治疗的患者。
14例单侧完全性唇腭裂（UCLP）患者（9例男性，5例女性）同意通过对其牙槽裂部位进行CAT扫描评估来参与本研究。他们还必须在CAT扫描后6个月内拍摄移植裂部位的根尖片或咬合片。
所有患者均接受了一期唇裂修复、放置被动腭板、一期牙槽骨移植（平均年龄6.4个月），并在1岁前进行了腭裂修复术。在进行影像学评估时，通过最终正畸完成了主要的牙齿移动。
将CAT扫描图像进行重新格式化和重建，以三维方式计算移植裂部位相邻15颗牙齿的牙根被骨支持覆盖的百分比。对同一牙齿的牙科X线片也进行了描绘和数字化处理。通过将牙根被骨覆盖的量除以解剖牙根长度，利用牙科X线片确定牙根被骨支持的百分比。
配对双样本t检验显示两种评估方法之间无显著差异，而线性回归显示CAT扫描评估结果与X线片上得出的百分比之间存在统计学上的显著相关性。
当对各分组进行比较时，常规牙科X线片能够在统计学显著程度上估计出CAT扫描所确定的腭裂相邻牙齿牙根的三维骨支持总量。对于个体病例评估的临床意义则不那么显著，存在广泛的变异性，且一致性水平要求接受高达25% 的差异。
