Alveolar Yarıklarda Preoperatif Yarık Hacmi Değerlendirilmesi ve Kemik greftleme Postoperatif Takibinde Objektif ve Güvenilir Yöntem: Yarık ve Kemik Grefti Hacminin Üç Boyutlu Rekonstrüksiyon Programıyla Ölçülmesi

Amaç: Çalışmanın amacı, ameliyat öncesi alveoler yarık hacminin ve ameliyat sonrası kemik greftlerinin hacminin bilgisayarda objektif olarak üç boyutlu rekonstrüksiyon programıyla değerlendirilmesidir.Gereç ve Yöntemler: Çalışma 6 unilateral, 2 bilateral komplet yarık dudak damaklı hastanın toplam 10 alveoler yarığında yapıldı. Tüm hastalarda sekonder otojen iliak kortikokansellöz kemik grefti kullanıldı. Ameliyat öncesi ve ameliyat sonrası erken dönemde aksiyal, koronal ve sagittal bilgisayarlı tomografi BT kesitleri alındı. Daha sonra bu kesitler üç boyutlu rekonstrüksiyon bilgisayar programı olan “mimics” ile, üç boyutlu modeller haline getirildi. Bulgular: Çalışmada, alveoler yarıklar için 0,316 ila 3,815 cm3 arasında değişen, ortalama 1,311 cm3lük kemik greftine ihtiyaç duyulduğu görülmüştür. Ameliyat sonrası değerlendirmelerde ise toplam 5 yarıkta, yarık hacminden fazla greft kullanıldığı, diğer 5 yarıkta ise yarık hacminin gerektirdiğinden daha az kemik grefti kullanılmış olduğu görüldü.Sonuç: Ameliyat öncesi dönemde “Mimics” programı ile hesaplanan yarık bölgesiyle birebir aynı şekil ve hacimdeki boşluk modelini üç boyutlu yazıcı ile elde etmek mümkündür. Bu modeller sayesinde ameliyat sırasında ihtiyaç duyulandan eksik veya fazla greft alınması ihtimali azalacak ve buna bağlı olarak morbidite, tekrarlayan ameliyatlar ve maliyet azalacaktır

Anahtar Kelimeler:

Alveoler yarık, Kansellöz kemik grefti, Kemiğin volumetrik değerlendirmesi

An and Reliable Method for Preoperative Cleft Volume Evaluation and Postoperative Bone Graft Follow-up in Alveolar Clefts: Measurement of the Cleft and Bone Graft Volume by Three-Dimensional Computerized Reconstruction Software

Objective: The purpose of the study was the objective evaluation of the preoperative alveolar cleft volume and postoperative bone graft volume using three-dimensional computerized reconstruction software.Material and Methods: The study was performed on a total of 10 alveolar clefts located in 6 patients with unilateral and 2 patients with bilateral complete cleft lip and palate. A secondary autogenous iliac corticocancellous bone graft was used in all patients. Axial, coronal, and sagittal computed tomography CT sections were acquired in the preoperative and early postoperative periods. These sections were then reconstructed using the “mimics” three-dimensional computerized reconstruction software.Results: A mean bone graft volume of 1,311 cm3, with a range of 0.316 to 3.815 cm3, was found to be necessary for the alveolar clefts. Postoperative evaluations revealed that the graft volume was larger than the cleft volume in 5 clefts and less than what was required for the cleft volume in the other 5 clefts.Conclusion: Using a three-dimensional printer, it is possible to produce a space model with shape and volume that are exactly the same as the cleft region as preoperatively calculated with the “Mimics” software. These models could enable avoiding the preparation of grafts with a volume that is larger or smaller than what is needed for the surgery, and therefore result in decreased morbidity, repeat surgery rate and cost

Keywords:

Alveolar cleft, Cancellous bone graft, Volumetric evaluation of bone,

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