title: Risk factor analysis of bone resorption following secondary alveolar bone grafting using three-dimensional computed tomography.
abstract: OBJECTIVE
  The purpose of this study is to analyze the risk factors for bone resorption following secondary bone grafting in the alveolar cleft, using three-dimensional (3D) computed tomography (CT) based on surgical simulation software (SimPlant OMS, Materialise Dental, Leuven, Belgium).
  
  
  METHODS
  We reviewed the secondary alveolar bone grafts performed by a single surgeon between January 2005 and January 2014. A total of 40 patients with unilateral alveolar cleft were included in this study. The grafted alveolar bone was measured using surgical simulation software. In order to validate the measurement, each data set was measured by three different analysts and the inter- and intraobserver variabilities were calculated. A total of eight risk factors for grafted bone survival, including patient age, sex, body mass index (BMI), palatal fistula, amount of grafted bone, dental appliance, canine or incisor eruption, and preoperative upper respiratory tract infection, were evaluated using the linear mixed model and Mann-Whitney test.
  
  
  RESULTS
  The average alveolar defect size was 4.98 cc and the average graft survival was 67.5%. The inter- and intraobserver variabilities of simulation software were 0.758 and 0.915, respectively. Among the risk factors, only dental appliance (p = 0.02) and canine eruption (p = 0.041) were significantly correlated with graft survival. Other risk factors, including the amount of grafted bone, did not show a significant relationship with graft survival.
  
  
  CONCLUSIONS
  Measurement of an alveolar bone defect using a simulation program based on 3D CT is reliable and reproducible. Secondary bone grafting survival was significantly correlated with canine eruption and dental appliance in the alveolar cleft.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
authors.forename: Tae Suk
authors.initials: TS
authors.lastname: Oh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
authors.forename: Joo Seok
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Eastman Dental Clinic, Seoul, South Korea.
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Kwon
authors.affiliation: Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea. Electronic address: kskoh@amc.seoul.kr.
authors.forename: Kyung S
authors.initials: KS
authors.lastname: Koh
mesh_terms: D000367:Age Factors; D064728:Alveolar Bone Grafting / Q000379:methods*; D015992:Body Mass Index; D001862:Bone Resorption / Q000000981:diagnostic imaging*; D002648:Child; D002972:Cleft Palate / Q000150:complications; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D016155:Oral Fistula / Q000150:complications; D012141:Respiratory Tract Infections / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012984:Software; D025321:Surgery, Computer-Assisted; D014078:Tooth Eruption; D016896:Treatment Outcome
keywords: Alveolar bone grafting; Bone transplantation; Cone beam computed tomography; Three-dimensional image