| Objective: A comprehensive three-dimensional evaluation method was used to evaluate the effect of bone graft in patients with unilateral alveolar cleft in the mental bone and iliac bone,and to provide a reference for the selection of clinical bone graft materials.Materials and methods: From January 2015 to September 2017(age 7-15),29 cases of unilateral alveolar cleft were found in the Affiliated Union Hospital of Fujian Medical University,including 19 men and 10 women.All patients were followed up for 6 months and above.CBCT(cone beam CT)imaging data of all patients before operation,one week after operation and 6 months after operation were collected.A total of 10 people were divided into three groups according to the bone graft materials: group A(patients using traditional iliac bone block with SABG),and group B(patients with SABG by using minimally invasive way of iliac cancellous bone),and group C(mental lump bone for SABG patients)in a total of 11 people.The collected CBCT data were introduced into Mimics 19 software for measurement and reconstruction.The measurements included implant bone height,bone width,fissure volume,and postoperative implant bone volume.According to the above index data,bone graft effect was compared,and SPSS19.0 and graphypad prism6.0 software were used for statistical analysis.Rusults:Three dimensional volume measurement results: group A(ilium bone block)has the highest bone formation rate,and B has the lowest bone ratio.By independent sample t test,A group compared with B group,****,P < 0.0001;A group compared with C group,*,P < 0.05.It shows that there is a significant difference in bone graft rate between A group and B group,A group and C group.Bone height measurement: buccal measurement point I type bone height ratio was significantly higher than palatal measurement point.The statistical results of chi square test for the measured data were P > 0.05,indicating that there was no significant difference in the distribution of height measurement grades in groups of A,B and C with different height of bone.The bone width measurement results showed that the I bone width accounted for the highest proportion in the C group,up to 63.6%,while the IV type bone width was the highest in the B group,reaching 62.5%.The statistical results of the chi square test for the measured data were P < 0.05,indicating that the differences in the bone width distribution of the three groups in the three groups were statistically significant.The total score of bone graft was the highest in group A and group C,which were 50% and 63.6% respectively.The proportion of D in B group was 62.5%.The statistical results of chi square test for the measured data were P < 0.05,indicating that the difference in the total score distribution of bone graft materials and bone graft in groups of A,B and C was statistically significant.Conclusion: the three dimensional comprehensive evaluation method proposed in this study can be used to evaluate the bone graft effect of alveolar cleft more accurately and can be applied to the clinic.Through the analysis of the results of this study,we think that the iliac bone block and chin bone are better SABG bone graft material in the clinical area for selection can be combined with the CBCT measurement of preoperative gap size,considering the required bone mass,donor site morbidity factors such as choosing suitable bone graft materials. |
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