The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2021
Mind the Gap: Alveolar Bone Graft Revision in the Era of Computed Tomography.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zubovic Ema, Skolnick Gary B, Said Abdullah M, Nissen Richard J, Snyder-Warwick Alison K, Patel Kamlesh B
Аннотация
OBJECTIVE: To determine the rate of revision alveolar bone grafting (ABG) in patients with cleft lip and palate (CLP) before and after the introduction of postoperative computed tomography (CT).
DESIGN: Retrospective case-control study analyzing the incidence of revision ABG in patients with and without postoperative CT scans for graft success evaluation.
SETTING: Academic tertiary care pediatric hospital.
PATIENTS: Eighty-seven patients with CLP or cleft lip and alveolus treated with autologous iliac crest bone grafting for alveolar clefts over a 10-year period (January 2009 to March 2019) with minimum 6-month follow-up. Fifty patients had postoperative CT evaluation; 37 did not.
INTERVENTIONS: Postoperative CT to determine ABG success, versus standard clinical examination and 2-dimensional radiographs.
MAIN OUTCOME MEASURES: Requirement for revision ABG, defined as failure of the original graft by clinical or radiographic examination.
RESULTS: Fifty-eight percent of patients underwent a postoperative CT scan at median interval of 10 months after surgery. Patients with postoperative CT evaluation had a 44% rate of revision ABG (22/50) for inadequate graft take, compared to 5% (2/37) in patients without postoperative CT (P < .001; 95% CT, 31%-58% in the CT group, 1%-16% in the non-CT group).
CONCLUSIONS: Computed tomography evaluation after ABG is associated with a significantly increased revision rate for inadequate graft take. The presence of a secondary palatal fistula at the time of original ABG is not associated with revision requirement. Lack of standardized dental and orthodontic records complicates the study of ABG outcomes and presents an area for systems-based improvement.
DESIGN: Retrospective case-control study analyzing the incidence of revision ABG in patients with and without postoperative CT scans for graft success evaluation.
SETTING: Academic tertiary care pediatric hospital.
PATIENTS: Eighty-seven patients with CLP or cleft lip and alveolus treated with autologous iliac crest bone grafting for alveolar clefts over a 10-year period (January 2009 to March 2019) with minimum 6-month follow-up. Fifty patients had postoperative CT evaluation; 37 did not.
INTERVENTIONS: Postoperative CT to determine ABG success, versus standard clinical examination and 2-dimensional radiographs.
MAIN OUTCOME MEASURES: Requirement for revision ABG, defined as failure of the original graft by clinical or radiographic examination.
RESULTS: Fifty-eight percent of patients underwent a postoperative CT scan at median interval of 10 months after surgery. Patients with postoperative CT evaluation had a 44% rate of revision ABG (22/50) for inadequate graft take, compared to 5% (2/37) in patients without postoperative CT (P < .001; 95% CT, 31%-58% in the CT group, 1%-16% in the non-CT group).
CONCLUSIONS: Computed tomography evaluation after ABG is associated with a significantly increased revision rate for inadequate graft take. The presence of a secondary palatal fistula at the time of original ABG is not associated with revision requirement. Lack of standardized dental and orthodontic records complicates the study of ABG outcomes and presents an area for systems-based improvement.