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Peer-reviewedCC BY-NC-NDPlastic and reconstructive surgery. Global open

A Dual-parameter 3D Assessment of Alveolar Cleft Bone Grafts: Integrating Bone Density and Modified Volumetry.

  1. 1From the Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Background

Alveolar cleft is a discontinuity of the maxillary alveolar process commonly associated with cleft lip and palate, leading to functional and aesthetic impairments. Secondary alveolar bone grafting (SABG) is the standard treatment to restore continuity. However, conventional postoperative evaluation relies solely on volume measurement. Although 3D computed tomography is widely used for this purpose, it ignores the porous, trabecular nature of newly formed bone (NFB), resulting in systematic underestimation of graft volume and incomplete assessment of regeneration.Methods

We developed a dual-parameter evaluation method that integrates bone density analysis with a modified 3D volumetric algorithm accounting for trabecular porosity. Preoperative and 6-month postoperative computed tomography scans from 37 patients with unilateral alveolar cleft who underwent autologous SABG were used to construct matched maxillary models. Bone quality was quantified by mean Hounsfield units (HUs), and volumetric accuracy was enhanced by correcting for the porous structure of NFB using Smart Fill technology.Results

The conventional Boolean subtraction method yielded a mean NFB ratio of 44.87%. With our Smart Fill-enhanced method, the NFB ratio significantly increased to 55.85% (absolute increase 10.98%, relative increase 24.47%; P < 0.001). The mean bone density of the graft was 483.01 ± 78.11 HU (range: 358.77-614.64 HU), consistent with the quality of trabecular bone.Conclusions

By simultaneously assessing the quantity (modified volume) and quality (density) of regenerated bone, this dual-parameter method provides a more accurate postoperative evaluation of SABG outcomes and can assist surgeons in clinical decision-making for alveolar bone repair.

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BibTeX
@article{deng2026dualparameter,
  title = {{A Dual-parameter 3D Assessment of Alveolar Cleft Bone Grafts: Integrating Bone Density and Modified Volumetry.}},
  author = {Menghao Deng and Siqi Wei and Yongqian Wang},
  journal = {Plastic and reconstructive surgery. Global open},
  year = {2026},
  month = oct,
  doi = {10.1097/gox.0000000000008191},
  url = {https://europepmc.org/article/MED/42948842},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - A Dual-parameter 3D Assessment of Alveolar Cleft Bone Grafts: Integrating Bone Density and Modified Volumetry.
AU  - Menghao Deng
AU  - Siqi Wei
AU  - Yongqian Wang
PY  - 2026
DA  - 2026/10/27
JO  - Plastic and reconstructive surgery. Global open
DO  - 10.1097/gox.0000000000008191
UR  - https://europepmc.org/article/MED/42948842
AB  - Background  Alveolar cleft is a discontinuity of the maxillary alveolar process commonly associated with cleft lip and palate, leading to functional and aesthetic impairments. Secondary alveolar bone grafting (SABG) is the standard treatment to restore continuity. However, conventional postoperative evaluation relies solely on volume measurement. Although 3D computed tomography is widely used for this purpose, it ignores the porous, trabecular nature of newly formed bone (NFB), resulting in systematic underestimation of graft volume and incomplete assessment of regeneration.Methods  We developed a dual-parameter evaluation method that integrates bone density analysis with a modified 3D volumetric algorithm accounting for trabecular porosity. Preoperative and 6-month postoperative computed tomography scans from 37 patients with unilateral alveolar cleft who underwent autologous SABG were used to construct matched maxillary models. Bone quality was quantified by mean Hounsfield units (HUs), and volumetric accuracy was enhanced by correcting for the porous structure of NFB using Smart Fill technology.Results  The conventional Boolean subtraction method yielded a mean NFB ratio of 44.87%. With our Smart Fill-enhanced method, the NFB ratio significantly increased to 55.85% (absolute increase 10.98%, relative increase 24.47%; P < 0.001). The mean bone density of the graft was 483.01 ± 78.11 HU (range: 358.77-614.64 HU), consistent with the quality of trabecular bone.Conclusions  By simultaneously assessing the quantity (modified volume) and quality (density) of regenerated bone, this dual-parameter method provides a more accurate postoperative evaluation of SABG outcomes and can assist surgeons in clinical decision-making for alveolar bone repair.
SN  - 2169-7574
ER  -