Application of limited cone beam computed tomography to clinical assessment of alveolar bone grafting: a preliminary report.

OBJECTIVES: The aim of this study was to demonstrate the clinical applicability of limited cone beam computed tomography (Dental 3D-CT) for assessment of bone-grafted alveolar cleft. PATIENTS AND METHODS: Seventeen bone bridges were examined after alveolar bone grafting in 13 patients with cleft lip and palate. All bone bridges, including cleft-adjacent teeth, were examined by plain radiography and the Dental 3D-CT imaging system. RESULTS: The plain radiographs showed the approximate condition of the bone bridge and cleft-adjacent teeth. The Dental 3D-CT images clearly showed precise three-dimensional (3D) morphology of the bone bridge, 3D relationships between the bone bridge and the roots of cleft-adjacent teeth, and their periodontal condition. In addition, the conditions surrounding dental implants installed in the bone bridge could be observed three-dimensionally. CONCLUSIONS: The results indicate that the Dental 3D-CT imaging system is suitable for clinical assessment of alveolar bone grafting before and after installation of dental implants or orthodontic treatment of the cleft-adjacent teeth.

Observation of choroidal circulation using index of erythrocytic velocity.

OBJECTIVE: To describe a noninvasive method to visualize choroidal circulation by means of erythrocytic velocity. METHODS: Laser speckle flowgraphy (LSFG) and indocyanine green (ICG) angiography were performed on 9 volunteers. The LSFG measures the quantitative relative velocity index of erythrocytes (normalized blur [NB] value) in retinal and choroidal vessels. We averaged NB values from 3 pulsations and made composite 1.5-mm-square NB maps during 1 pulsation. By overlapping 5 adjacent maps, we created a panoramic 3.0-mm-square NB map of the posterior pole. The vascular patterns of the panoramic map and ICG angiography were compared. To determine the influence of retinal vessels, we induced branch retinal artery occlusion in 2 monkey eyes and compared the panoramic maps before and after occlusion. RESULTS: The NB map showed pulsatile blood flow in choroidal and retinal vessels. Vascular pattern contrast was improved in the NB map. Choroidal vessels in ICG angiography corresponded to those in the NB map. Vascular patterns in the map changed little before and after branch retinal artery occlusion. CONCLUSIONS: The LSFG noninvasively visualized the hemodynamics of choroidal circulation, and the vascular pattern, which is mainly choroidal in origin, was comparable with that of ICG angiography. CLINICAL RELEVANCE: The LSFG may be used to evaluate choroidal hemodynamics in various choroidal diseases.

The reconstruction of bilateral clefts using endosseous implants after bone grafting.

This article presents the orthodontic reconstruction of an adult bilateral cleft patient with a severe Class III malocclusion in which endosseous implants were inserted after secondary alveolar bone grafting. The patient was a 21-year-old Japanese male whose lateral incisors were congenitally missing and whose premaxilla was inclined lingually. The occlusion was classified as Angle Class III with an overjet of -8 mm. Orthodontic alignment was initiated to correct the position of the maxillary incisors before bone grafting. After the anterior occlusal relationship was corrected, bilateral alveolar clefts were reconstructed by bone grafting with autogenous particulate marrow and cancellous bone harvested from the iliac crest. ITI-SLA fixtures (Institute Straumann, Waldenburg, Switzerland) (length, 10 mm; diameter, 4.1 mm) were placed into the grafted bone for prosthetic restoration of the missing lateral incisors. The results illustrate that this protocol can be expected to provide an acceptable occlusion and good dentoalveolar stability in adult cleft patients.