JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2020, Vol. 40 ›› Issue (10): 1414-1419.doi: 10.3969/j.issn.1674-8115.2020.10.020

• Original article (Clinical research) • Previous Articles     Next Articles

Correlation between the morphology of alveolar bone defect in the maxillary anterior region and the outcome of guided bone regeneration

LI Yuan, SHI Jun-yu, ZHANG Xiao, LAI Hong-chang   

  1. Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Institute of Stomatology, Shanghai 200011, China
  • Online:2020-10-28 Published:2020-11-27
  • Supported by:
    Clinical Research Plan of Shanghai Shenkang Hospital Development Center (16CR3033A); Shanghai Clinical Research Center Program for Oral Diseases (19411950100); Multicenter Clinical Research Program of Shanghai Jiao Tong University School of Medicine (DLY201822).

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Abstract: Objective · To analyze the influence of the initial ridge defect morphology on the outcome of guided bone regeneration (GBR) in the maxillary anterior region. Methods · This retrospective study included patients being placed with simultaneous GBR in the implant in the maxillary anterior region from May 2018 to September 2019 in the Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital. Cone beam CT (CBCT) examinations of patients were used to measure the resorption rate of grafted bone from the moment to 6 months after surgery. The 3D surface rendering of initial defect was reconstructed based on preoperative CBCT, and morphological variables were defined in mesial-distal, buccal-lingual, and coronal-apical directions. The Spearman correlation, Logistic regression model and receiver operating characteristic (ROC) curve analysis were used to assess the possible association between initial defect morphological variables and the resorption rate of grafted bone. A prediction model was established and verified by the leave-one-out cross-validation method. Results · A total of 30 patients were included and the median value of resorption rate of grafted bone was 52.1%. The correlation analysis results showed that the resorption rate of grafted bone was significantly correlated with multiple morphological variables of initial bone defect. The results of multivariate Logistic regression analysis showed that the maximum buccal-lingual distance (mBL) of the initial bone defect and the ratio of the of maximum coronal-apical / mesial-distal distance (rmCA/mMD) were the main factors affecting the resorption rate of grafted bone. The ROC curve analysis results showed that the area under the curve of mBL- and rmCA/mMD-based prediction model to predict the postoperative resorption rate of grafted bone was 0.946. The results of the leave-one-out cross-validation method showed that the prediction accuracy of the model was 76.7%, and the sensitivity and specificity were 0.714 and 0.813, respectively. Conclusion · The initial bone defect morphology has a significant effect on the outcome of the GBR 6 months after surgery, and bone defect morphological variables have a good predictive effect on the resorption rate of grafted bone.

Key words: alveolar bone defect, guided bone regeneration (GBR), cone beam CT (CBCT), morphological contour interpolation

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