Aim:Iliac crest(IC)is the most common source of bone for alveolar cleft repair,as it allows for harvesting a large amount of cancellous bone with a high rate of favorable outcomes.Its drawback is the donor-site morbid...Aim:Iliac crest(IC)is the most common source of bone for alveolar cleft repair,as it allows for harvesting a large amount of cancellous bone with a high rate of favorable outcomes.Its drawback is the donor-site morbidity.We propose a new technique for alveolar cleft grafting using vomerine bone(VB),which,through bone grafting,reconstructs the alveolus with the VB and simultaneously corrects the nasal septum deviation.Method:We performed 18 alveolar reconstructions with VB in patients with a small bony defect and septal deviation,which would benefit from septoplasty.A matched control group with IC bone grafting was selected.Panoramic X-rays were used for vertical assessment of ossification with the Bergland scale and CT scans for the evaluation of the thickness of the grafted area in the VB and IC groups and compared with an independent samples T-test.A paired T-test compared angular measurements of the septal deviation pre-and post-vomerine grafting.Results:All grafts healed uneventfully,with no complications at the donor site and respiratory function was improved.There was no statistically significant difference in ossification height between VB and IC,the alveolar thickness at the occlusal and middle third was higher with IC.Septal deviation was reduced significantly.Conclusion:Alveolar graft from VB seems to be a viable alternative to IC in patients who present with a mild bony alveolar defect in addition to septal deviation,allowing combined procedures while reducing the morbidity of the donor site.展开更多
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
文摘Aim:Iliac crest(IC)is the most common source of bone for alveolar cleft repair,as it allows for harvesting a large amount of cancellous bone with a high rate of favorable outcomes.Its drawback is the donor-site morbidity.We propose a new technique for alveolar cleft grafting using vomerine bone(VB),which,through bone grafting,reconstructs the alveolus with the VB and simultaneously corrects the nasal septum deviation.Method:We performed 18 alveolar reconstructions with VB in patients with a small bony defect and septal deviation,which would benefit from septoplasty.A matched control group with IC bone grafting was selected.Panoramic X-rays were used for vertical assessment of ossification with the Bergland scale and CT scans for the evaluation of the thickness of the grafted area in the VB and IC groups and compared with an independent samples T-test.A paired T-test compared angular measurements of the septal deviation pre-and post-vomerine grafting.Results:All grafts healed uneventfully,with no complications at the donor site and respiratory function was improved.There was no statistically significant difference in ossification height between VB and IC,the alveolar thickness at the occlusal and middle third was higher with IC.Septal deviation was reduced significantly.Conclusion:Alveolar graft from VB seems to be a viable alternative to IC in patients who present with a mild bony alveolar defect in addition to septal deviation,allowing combined procedures while reducing the morbidity of the donor site.
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.
