唇腭裂二期牙槽突植骨二维与三维影像评价方法的对比分析

目的　探讨二维X线片与CT扫描及三维重建在评价唇腭裂二期牙槽突植骨疗效中的一致性。方法　选择唇腭裂二期牙槽突植骨术后半年以上的唇腭裂 9例 (单侧完全性唇腭裂 8例 ,双侧完全性唇腭裂 1例 ) ,牙槽突裂隙为 10侧。年龄范围 12～ 2 6岁 ,平均年龄 15 5岁。患者首先拍摄上颌前部咬合片 ,经Bergland分级标准确定为 :Ⅰ型 :2侧 ;Ⅱ型 :2侧 ;Ⅲ型 :5侧 ;Ⅳ型 :1侧。在上颌前部咬合片拍摄后的 2个月内 ,进行上颌骨CT扫描及三维重建。结果　上颌前部咬合片所示裂隙植骨区牙槽骨的高度被CT证实。CT检查发现有 2个裂隙植骨区存在唇、腭侧凹陷。结论　唇腭裂牙槽突植骨后 ,在正畸前仍然可以使用上颌前部咬合片进行牙槽突植骨疗效的评价。但同时应注意观察X线片植骨区牙槽骨的密度和临床检查 ,必要时应该进行CT检查

The comparison of two-dimensional and three-dimensional methods in the evaluation of the secondary alveolar bone grafting

OBJECTIVE: To determine the agreement between two-dimensional radiograph and three-dimensional CT in the evaluation of the secondary alveolar bone grafting. METHODS: Nine complete cleft lip and palate patients (8 UCLP, 1 BCLP) at least 6 months post secondary alveolar bone grafting were selected. The mean age of the patients was 15.5 years with a range of 12 to 26 years. Occlusal radiographs were taken and the interdental septal height was determined using Bergland criteria. There were 2 type I sites, 2 type II sites, 5 type III sites and 1 type IV site. All the patients had undergone CT scan of the cleft within two months after the radiograph was taken. The plane of scan was parallel to the occlusal plane. Cuts of 2 mm were taken from the infraorbital rim to the gingival third of the crown of the teeth. Three-dimensional reconstruction was performed. RESULTS: The interdental septal height on the occlusal radiograph was conformed by the CT scan. Labial and palatal notch was found on CT scan at two grafting sides. CONCLUSIONS: The study provided some evidence to support the continued cautious use of anterior occlusal radiograph in the evaluation of bone-graft success before the orthodontic treatment. When the X-ray examination is not in line with the clinical examination, CT scan is indicated.