CBCT-Based Analysis of Factors Influencing the Quality of New Bone Formation Following Mandibular Distraction Osteogenesis in Children With Pierre Robin Sequence.

Abstract

The aim of this study was to explore the factors influencing the quality of new bone formation after distraction osteogenesis in children with Pierre Robin sequence (PRS). Using cone-beam computed tomography (CBCT), bone density relative grayscale values of the region of new bone formation before and 3 to 4 months after mandibular distraction osteogenesis (MDO) were measured in 80 children with PRS, and correlation analysis was conducted with the potential clinical influencing factors of the children. CBCT reconstruction of the panoramic film showed that the new bone formation was good at 3 to 4 months after MDO. There was a statistically significant difference in the gray value of cancellous bone before and after the operation (P<0.01). The gray values of bilateral mandibular new bone after MDO were related to cleft palate, preoperative weight, preoperative body mass index (BMI), and distraction length. Finally, the variables included in the multiple linear regression model were cleft palate and preoperative BMI. At 3 to 4 months after MDO, the mineralization degree of cancellous bone in the central region of the bilateral mandibular new bone formation area was lower. The presence of cleft palate and preoperative BMI were identified as the main factors influencing the new bone formation in bilateral mandibles after MDO. This may be attributed to the catch-up nutritional acquisition and growth promotion in children, which facilitates new bone formation, along with greater chewing muscle strength to prevent mineral loss from bones.