Differences in bone remodeling using demineralized bone matrix in bilateral sagittal split ramus osteotomy: a study on volumetric analysis using three-dimensional cone-beam computed tomography.
OBJECTIVE
The aim of this study was to examine the effects of demineralized bone matrix (DBM) grafts on bone remodeling during sagittal split ramus osteotomy by measuring 3-dimensional (3D) reconstructed images.


METHODS
Forty-eight patients were selected for this study. In the control group, no grafts were performed. In the DBM group, DBX grafts were placed between the proximal and distal segments. Three-dimensional cone-beam computerized tomographic (3D-CBCT) images were obtained within 1 week, after 3 months (T2), and after 6 months (T3) postoperatively. By measuring the total skeletal volume from the right condylar head to the right mandibular first molar, the volume of the graft site was measured indirectly. Using the data thus obtained, a volume-increasing ratio (percentage) was computed. SimPlant analytical software was used to analyze the 3D reconstructed volumes.


RESULTS
The 2 groups showed a significant increase in volume. However, in the same period, the volume-increasing ratios of the 2 groups showed significant differences. In the control group, a significant increase in volume was seen until T2, after which a negligible increase was seen. Conversely, in the DBM group, a significant volume increase continued until T3.


CONCLUSIONS
In orthognathic surgeries, grafting using DBM is a favorable procedure that accelerates bone formation. Therefore, in cases with inevitable large bony gaps, DBM grafts can play a positive role in the stable healing of segments and the prevention of postoperative complications. Moreover, because volumetric analysis using 3D-CBCT analyzing software is a fast and simple method, future studies using this technique are expected to increase.
Professor and Chairman, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea.
Baek-Soo
BS
Lee
Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea. Electronic address: ojyoung81@gmail.com.
Joo-Young
JY
Ohe
Graduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea.
Bae-Kyung
BK
Kim
D000293:Adolescent; D000328:Adult; D064591:Allografts / Q000000981:diagnostic imaging / Q000637:transplantation*; D018775:Bone Demineralization Technique; D001857:Bone Matrix / Q000000981:diagnostic imaging / Q000637:transplantation*; D016723:Bone Remodeling / Q000502:physiology*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D019186:Mandibular Advancement / Q000379:methods; D010012:Osteogenesis / Q000502:physiology; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D012189:Retrospective Studies; D014021:Tissue Preservation; D055815:Young Adult