[Assessment of bone grafting mineralization in patients with alveolar clefts using digital radiography]
Teresa Mikołajczak1, Grazyna Wilk, Elzbieta Gawrych
1Katedra i Zakład Radiologii Ogólnej i Stomatologicznej Pomorskiej Akademii Medycznej w Szczecinie, Szczecin.
Introduction:
The objective of the work was to assess the suitability of digital radiography with the option of tomosynthesis for the purpose of mineralization of bone, grafted to the alveolar cleft fissure. Moreover the assessment of the influence of the patients age on the operation date on the transplanted bone mineralization degree was carried out. Furthermore, an attempt to compare the density of the transplanted bone to the density of the bone on the opposite side was taken on the basis of pantomographs. Additionally, the level of oral cavity hygiene and its influence on mineralization of the bone transplant were discussed.
Material And Methods:
27 patients with complete cleft lip and palate, who underwent operation of autogenic bone graft to alveolar process were investigated. During clinical examination, information about the patients age on their operation date were collected, and DMF and OHI indicators were defined. Control digital intraoral X-rays of all patients aimed at the cleft area were taken. Additionally, conventional pantomographs of 18 patients for orthodontic indications were taken. Relative values of the grafted and healthy bones were defined on the basis of the intraoral and pantomographic images with the use of software Digora (Soredex).
Results:
The relative density of bone grafts, whose range was established by the means of the tomosynthesis option, and which was obtained through the analysis, was 87.8 and in the healthy bone (adjacent to transplant) - 149.2. The values of relative thickness of the transplanted and healthy bones were established on the basis ofpantomographs and proved to be lower than those obtained with the intraoral images. A statistical analysis of the intraoral images showed a substantial difference between the established values of the healthy and transplanted bones. In addition, the dependence between the degree of mineralization and the patients age on the day of the operation was observed. It was proven that the younger the patient was on that day, the higher the transplanted bone thickness was. Based on average values of DMF and OHI indicators, a high intensivity of caries was found in 78.3%, a good hygienic condition of the oral cavity in 78.3% and a satisfactory value in 21.7% of the cases.
Conclusions:
1. Mineralization of the bone grafts to alveolar fissure, based on relative bone thickness obtained by use of an intraoral digital X-rays, differes significantly from the healthy bone. 2. Relative density of the bone grafts is highly dependent on the patient's age on the day of the operation: the younger the patient is, the better mineralization of the bones is. 3. Digital radiography with the option oftomosynthesis is very useful for establishing the scope of the bone grafts and, indirectly, for assessment of its mineralization. 4. Pantomography is not useful for assessment of density of bone grafts of cleft patients. 5. Cleft palate patients were found to have a good hygienic level and a high intensivity of caries. 6. A lowered relative thickness of bone grafts and a higher value of DMF indicator were observed in female patients.
