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ABSTRACT: To determine the bone absorption at different time after alveolar autogenous bone grafting using spiral CT three-dimensional reconstruction.
Twenty unilateral cleft lip and palate patients(15 males,5 females) were chosen to undergo three-dimensional CT scans after alveolar bone graft, region of interest(ROI) volume measurement of GE AW 4.1 software was used to calculate the capacity of alveolar cleft at 1 week, 3 months, 6 months after surgery.
An average bone loss of 35.74% was found after 3 months, 55.89% after 6 months. In labial and palatal direction, labial bony bridge was more obvious than palatal bony bridge.
Bone resorption is present after alveolar bone graft, and becomes more severe with time going on. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality(08DZ2271100).
Shanghai kou qiang yi xue = Shanghai journal of stomatology 06/2012; 21(3):308-11.
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ABSTRACT: To establish a method to analyze malformed maxillae of postoperative adult patients with unilateral complete cleft lip and palate in 3 dimensions.
A total of 35 landmarks were defined and used to reconstruct 3-dimensional maxillary images of healthy Chinese Han subjects and 30 postoperative Chinese Han adult patients (17 men and 13 women, with mean age of 19.07 years) with unilateral complete cleft lip and palate. This was done using spiral computed tomography, and their corresponding parameters were analyzed using SimPlant software, version 11.04, and compared by t test using SAS software, version 6.12.
Of the 7 centered landmarks, A and ANS in the patients were obviously deviated to the nonoperative side (P < .01) and the symmetrical landmark pairs INM'-INM, SNM'-SNM and SPr'-SPr, but not MA'-MA, SoF'-SoF, and LPAC-LPA in the infraorbital region and piriform aperture peritreme in healthy subjects were shifted toward the coordinate sagittal plane S. The data also showed that the maxillae in the patients' operative side were hypoplastic, especially in the posteroanterior direction compared with the nonoperative side and healthy subjects.
The proposed method can precisely measure the distances of the maxillary landmarks to 3-dimensional coordinates and has application potential in evaluating maxillary deformity in patients with postoperative unilateral complete cleft lip and palate.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 12/2011; 69(12):e549-57. · 1.58 Impact Factor
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ABSTRACT: Secondary bone grafting plays an important role in the multimodal therapy of patients with cleft lips, alveoli, or palates. Through a comparative study of the nasal profile before and after alveolar bone grafting, this article aimed to determine the appropriate timing of operation and keys to success.
In the study, 38 cases (23 boys and 15 girls aged 9-13 years, with an average of 11.4 years) were examined of patients with unilateral cleft lips or palates, upon whom secondary bone grafting was performed under general anesthesia. Comparative studies are conducted on their nostril widths and heights in both the cleft side and the noncleft side as well as the widths and angles of the alar bases measured in the preoperative, postoperative, and follow-up (6 months) periods respectively.
Of the 29 cases examined 6 months after the operation, 4 indicate failure as the amount of bone loss exceeds 50%, whereas in the other 25 cases, both the nostril widths of the cleft side have increased, and the nostril heights of the cleft side have decreased significantly (P < 0.01).
As shown in the study, the nasal profile after alveolar bone grafting is changed obviously; thus, it is recommended that patients not receive rhinoplasty before bone grafting or have both operations at the same time.
The Journal of craniofacial surgery 11/2010; 21(6):1904-7. · 0.81 Impact Factor
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ABSTRACT: To present a classification of the deviated nose with unilateral cleft lip and the associated surgical correction.
A total of 176 cases of nasal deformities with unilateral cleft lip treated in Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine & Shanghai Research Institute of Stomatology & Shanghai Key Laboratory of Stomatology from 2007 to 2009 were analyzed. Depending on the relationship between the external pyramid and the facial midline, the nasal deviations with cleft lip were classified into 3 types: I, deviated bony pyramid, II, deviated cartilaginous pyramid; III, deviated lobular. The surgical treatment included surgical correction of deviated bony pyramid, deviated cartilaginous pyramid, deviated lobular and deviated septa.
Among the 176 patients, there were 97 males and 79 females, aging from 16 to 42 years with a mean of 20. There were 93 patients without deviated and 83 patients with deviated. Among the 83 deviated patients, deviated bony pyramid was found in 8 (10%), deviated cartilaginous pyramid in 29 (35%), deviated lobular in 46 (55%). Most patients who underwent surgical correction were satisfied.
There were nearly half of the unilateral cleft lip nasal deformity presenting with deviated noses. There was least deviated bony pyramid and most deviated lobular in the unilateral cleft lip deviated nose. The proposed classification for the deviated nose with unilateral cleft lip could serve as a practical guide for surgical planning.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 10/2010; 45(10):581-3.
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ABSTRACT: Comparing the survey results of 224 Centers of Cleft Lip and Palate in the United States with the current status in China, and reviewing the experience and lessons systemically, we could get a conclusion that the repair of cleft lip and palate depends on the experience and excellent skills of the surgeons, and its important role in combined and sequential treatment (team approach) of cleft lip and palate should not be ignored. The team approach program requires multidisciplinary cooperation and good compliance of the patients. In order to improve the treatment outcomes of cleft lip and palate, it is necessary for us to study the advanced program and methods and combined the situation of our country.
Shanghai kou qiang yi xue = Shanghai journal of stomatology 05/2006; 15(2):113-6.
