PurposeThis study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system.Materials and MethodsThe occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test.ResultsThe pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 (404.27±103.72/117.73±92.25; p=0.00), group 1 (434.29±86.70/388.31±109.51; p=0.01), and group 4 (430.98±98.11/366.71±154.59; p=0.02). No significant differences were found in group 2 (423.57±98.12/383.47±135.88; p=0.06) or group 3 (433.02±116.07/384.16±146.55; p=0.19).ConclusionBased on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.
Cleidocranial dysplasia (CCD) is a rare congenital disorder with prolonged retention of the primary teeth, unerupted permanent teeth, and supernumerary teeth. We report a 19-year-old well-developed and well-nourished Thai woman who presented with intermittent dull pain in the lower left jaw for about a week. CCD was diagnosed based on a panoramic radiograph that revealed 32 unerupted teeth affecting all four quadrants of her jaw. Chest and skull radiographs were added to evaluate the clavicles and skull bone formation to confirm the diagnosis of CCD. Family members, including parents and siblings, were radiographically investigated and showed no abnormality. After a 6-h first operation in the lower left jaw to remove five supernumerary teeth, a deciduous canine, and a permanent third molar, three-dimensional imaging by cone-beam computed tomography was conducted as an aid for planning further dental surgery and orthodontic treatment. A second operation was conducted to remove the other unerupted teeth in the four quadrants in 6 h, the same as the initial operation time, although the second involved the whole jaw, as compared with the first operation in only one quadrant.
BackgroundThree-dimensionally printed hydroxyapatite (3DP HA) was investigated in regards to its functional properties supporting bone regeneration and tooth movement. The material’s high porosity and nanocrystal structure were investigated in terms of degradability, wicking property, and granular agglomeration in order to identify its potential for use as bone graft in alveolar cleft applications. Materials and methodsCommercially available bovine xenograft (Bio-Oss), biphasic calcium phosphate alloplast (BoneCeramic), and two types of freeze-dried bone allograft granules (SureOss Plus and RegenOss) were employed as control samples for comparison. In vitro degradability was studied by submerging the samples in pH 7.4 buffered solution at 37 o C for 28 days and determining subsequent weight loss percentage. The wicking property and granular agglomeration were evaluated by putting the granules in contact with deionized water, whole blood, and phosphate-buffered saline (PBS).ResultSureOss Plus and RegenOss showed the greatest weight loss at 28 days (6.64 and 8.91%, respectively) followed by 3DP HA (2.82%), Bio-Oss (0.21%), and BoneCeramic (0.20%). In contrast, 3DP HA showed significantly greater wicking ability than other samples for all types of tested liquids. SureOss Plus exhibited the greatest granular agglomeration for all liquid types followed by 3DP HA and Bio-Oss, Regenoss, and BoneCeramic, respectively.Conclusion3DP HA was found to be a favorable candidate for bone grafting in alveolar cleft treatment. Its resorption ability and exceptionally high wicking ability would be beneficial in bone healing and tooth movement. In addition, its moderate granular agglomeration capacity would help in graft handling and manipulation.
Three-dimensionally printed hydroxyapatite (3DP HA) was investigated in regards to its functional properties supporting bone regeneration and tooth movement in alveolar cleft applications. Commercially available bovine xenograft (BXG), biphasic calcium phosphate alloplast (BCP), and two types of freeze-dried bone allograft granules (FDBA and FDBA-CMC) were employed as control samples. Degradability was studied by submerging the samples in pH 7.4 buffered solution at 37°C for 28 days and determining subsequent weight loss percentage. The wicking property and granular agglomeration were evaluated by putting the granules in contact with deionized water, blood, and phosphate-buffered saline (PBS). Both of FDBA and FDBA-CMC showed the greatest weight loss at 28 days followed by 3DP HA. In contrast, 3DP HA showed significantly greater wicking ability than other samples for all liquid types. FDBA-CMC exhibited the greatest granular agglomeration for all liquid types followed by 3DP HA. 3DP HA was found to be a favorable candidate for bone grafting in alveolar cleft treatment.
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