The purpose of this study was to assess the alveolar defect volume in unilateral cleft lip and palate (UCLP) subjects using computed tomography (CT) and a free software program to evaluate the intra- and inter-rater m...The purpose of this study was to assess the alveolar defect volume in unilateral cleft lip and palate (UCLP) subjects using computed tomography (CT) and a free software program to evaluate the intra- and inter-rater measurements, and to compare the cleft volume between age and affected side. The sample of this retrospective study consisted of 20 UCLP individuals, 12 boys and 8 girls, mean age 10.3 ± 2.4 years at the beginning of orthodontic treatment. All subjects required alveolar bone grafting. CT scans of the cleft area were obtained prior to secondary bone grafting, and were analyzed using Image J. software program. The cleft volume was calculated based on axial cross-sectional CT images by two raters (orthodontist and radiologist) and by the same rater (orthodontist) at two different moments. Linear mixed model, Bland-Altman, Pearson’s and intraclass correlation coefficient (ICC) were used. The mean cleft volume was 7.53 ± 1.55 mm3. The intra- and inter-rater measurements were reproducible (ICC = 0.976 and 0.963, respectively) with no significant difference between them. There were no statistically significant differences in the cleft volume related to age or cleft location. The assessment of cleft volume in UCLP using CT images and a free software program was a reproducible method. There was no significant relation between alveolar defect volume and age or cleft location.展开更多
目的：通过锥形束CT观察测量上颌切牙即刻种植的手术当日与术后6个月牙槽嵴骨板水平向和垂直向的变化量,为前牙即刻种植治疗设计提供临床参考。方法：选取2010年8月至2011年11月于北京大学口腔医院种植科行上颌切牙即刻种植患者20例（...目的：通过锥形束CT观察测量上颌切牙即刻种植的手术当日与术后6个月牙槽嵴骨板水平向和垂直向的变化量,为前牙即刻种植治疗设计提供临床参考。方法：选取2010年8月至2011年11月于北京大学口腔医院种植科行上颌切牙即刻种植患者20例（其中男性7例,女性13例）,平均年龄（28.41±10.22）岁（20~40岁）,共即刻植入23颗种植体于上前牙新鲜拔牙窝内,不进行即刻修复。术后即刻及术后6个月拍摄锥形束CT,分别测量种植体肩台下0、2、4、6、8 mm处[分别设为测量点1（measuring point 1,MP1）、MP2、MP3、MP4、MP5]牙槽嵴宽度变化及牙槽间隔中心点垂直向高度的变化。术前及永久修复后1年,通过临床检查对牙间乳头高度和唇侧丰满度进行评分。使用SPSS 20.0进行相关统计学分析。结果：所有种植体在永久修复后追踪两年,存留率100%。所有患牙位术后各个位点牙槽嵴水平向宽度均发生了一定程度的吸收改建,在种植体肩台下0、2、4、6 mm等处4个位点术前与术后比较差异均有统计学意义。各位点牙槽嵴水平向宽度分别为：MP1术前为（7.68±0.70）mm,术后为（7.00±0.76）mm;MP2术前为（7.81±0.87）mm,术后为（7.30±0.96）mm;MP3术前为（8.12±1.14）mm,术后为（7.62±1.20）mm;MP4术前为（8.48±1.57）mm,术后为（7.73±1.35）mm,P值分别为0.004,0.034,0.018,和0.016,均〈0.05,术后与术前值相减为牙槽嵴宽度减少量,变化程度较大的测量点为M1和M4,分别为（-0.89±2.06）mm和（-0.74±1.28）mm。牙槽间隔垂直向吸收量在不同系统结果不同：Ankylos系统为（-0.42±1.24）mm,Repalce系统为（-0.91±1.96）mm,经过配对t检验,差异无统计学意义。种植术前唇侧丰满度指数（labial convexity score,LCS）为3的有18个牙位,LCS为4的有2个;永久修复后1年LCS为2的有14个,LCS为3的有5个。术前牙间乳头指数（papilla index score,PSI）为2的有5个牙位,PSI为3的有15个牙位;永久修复后1年PSI为2的有7个牙位,PSI为3的有13个牙位,经过Willcoxon秩和检验,术前与永久修复后1年LCS比较差异均有统计学意义（P〈0.001）,PSI术前与永久修复后1年比较变化差异无统计学意义（P=0.157）。结论：即刻种植术后不能避免牙槽嵴改建而导致的牙槽骨改建吸收;即刻种植后切牙牙间乳头高度可以得到较好的维持,唇侧软组织丰满度由于牙槽骨改建而难以维持;即刻种植修复存在美学风险。展开更多
文摘The purpose of this study was to assess the alveolar defect volume in unilateral cleft lip and palate (UCLP) subjects using computed tomography (CT) and a free software program to evaluate the intra- and inter-rater measurements, and to compare the cleft volume between age and affected side. The sample of this retrospective study consisted of 20 UCLP individuals, 12 boys and 8 girls, mean age 10.3 ± 2.4 years at the beginning of orthodontic treatment. All subjects required alveolar bone grafting. CT scans of the cleft area were obtained prior to secondary bone grafting, and were analyzed using Image J. software program. The cleft volume was calculated based on axial cross-sectional CT images by two raters (orthodontist and radiologist) and by the same rater (orthodontist) at two different moments. Linear mixed model, Bland-Altman, Pearson’s and intraclass correlation coefficient (ICC) were used. The mean cleft volume was 7.53 ± 1.55 mm3. The intra- and inter-rater measurements were reproducible (ICC = 0.976 and 0.963, respectively) with no significant difference between them. There were no statistically significant differences in the cleft volume related to age or cleft location. The assessment of cleft volume in UCLP using CT images and a free software program was a reproducible method. There was no significant relation between alveolar defect volume and age or cleft location.
文摘目的：通过锥形束CT观察测量上颌切牙即刻种植的手术当日与术后6个月牙槽嵴骨板水平向和垂直向的变化量,为前牙即刻种植治疗设计提供临床参考。方法：选取2010年8月至2011年11月于北京大学口腔医院种植科行上颌切牙即刻种植患者20例（其中男性7例,女性13例）,平均年龄（28.41±10.22）岁（20~40岁）,共即刻植入23颗种植体于上前牙新鲜拔牙窝内,不进行即刻修复。术后即刻及术后6个月拍摄锥形束CT,分别测量种植体肩台下0、2、4、6、8 mm处[分别设为测量点1（measuring point 1,MP1）、MP2、MP3、MP4、MP5]牙槽嵴宽度变化及牙槽间隔中心点垂直向高度的变化。术前及永久修复后1年,通过临床检查对牙间乳头高度和唇侧丰满度进行评分。使用SPSS 20.0进行相关统计学分析。结果：所有种植体在永久修复后追踪两年,存留率100%。所有患牙位术后各个位点牙槽嵴水平向宽度均发生了一定程度的吸收改建,在种植体肩台下0、2、4、6 mm等处4个位点术前与术后比较差异均有统计学意义。各位点牙槽嵴水平向宽度分别为：MP1术前为（7.68±0.70）mm,术后为（7.00±0.76）mm;MP2术前为（7.81±0.87）mm,术后为（7.30±0.96）mm;MP3术前为（8.12±1.14）mm,术后为（7.62±1.20）mm;MP4术前为（8.48±1.57）mm,术后为（7.73±1.35）mm,P值分别为0.004,0.034,0.018,和0.016,均〈0.05,术后与术前值相减为牙槽嵴宽度减少量,变化程度较大的测量点为M1和M4,分别为（-0.89±2.06）mm和（-0.74±1.28）mm。牙槽间隔垂直向吸收量在不同系统结果不同：Ankylos系统为（-0.42±1.24）mm,Repalce系统为（-0.91±1.96）mm,经过配对t检验,差异无统计学意义。种植术前唇侧丰满度指数（labial convexity score,LCS）为3的有18个牙位,LCS为4的有2个;永久修复后1年LCS为2的有14个,LCS为3的有5个。术前牙间乳头指数（papilla index score,PSI）为2的有5个牙位,PSI为3的有15个牙位;永久修复后1年PSI为2的有7个牙位,PSI为3的有13个牙位,经过Willcoxon秩和检验,术前与永久修复后1年LCS比较差异均有统计学意义（P〈0.001）,PSI术前与永久修复后1年比较变化差异无统计学意义（P=0.157）。结论：即刻种植术后不能避免牙槽嵴改建而导致的牙槽骨改建吸收;即刻种植后切牙牙间乳头高度可以得到较好的维持,唇侧软组织丰满度由于牙槽骨改建而难以维持;即刻种植修复存在美学风险。
