Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis
Identifieur interne : 000352 ( Pmc/Curation ); précédent : 000351; suivant : 000353Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis
Auteurs : Hyeong-Geun Lee [Corée du Sud] ; Yong-Deok Kim [Corée du Sud]Source :
- Journal of the Korean Association of Oral and Maxillofacial Surgeons [ 2234-7550 ] ; 2015.
Abstract
The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated.
Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images.
No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%.
Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.
Url:
DOI: 10.5125/jkaoms.2015.41.5.232
PubMed: 26568924
PubMed Central: 4641213
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<author><name sortKey="Lee, Hyeong Geun" sort="Lee, Hyeong Geun" uniqKey="Lee H" first="Hyeong-Geun" last="Lee">Hyeong-Geun Lee</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff>
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<author><name sortKey="Kim, Yong Deok" sort="Kim, Yong Deok" uniqKey="Kim Y" first="Yong-Deok" last="Kim">Yong-Deok Kim</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff>
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<affiliation wicri:level="1"><nlm:aff id="A2">Dental Research Institute and Institute of Translational Dental Sciences, Pusan National University, Yangsan, Korea.</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis</title>
<author><name sortKey="Lee, Hyeong Geun" sort="Lee, Hyeong Geun" uniqKey="Lee H" first="Hyeong-Geun" last="Lee">Hyeong-Geun Lee</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Corée du Sud</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan</wicri:regionArea>
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</author>
<author><name sortKey="Kim, Yong Deok" sort="Kim, Yong Deok" uniqKey="Kim Y" first="Yong-Deok" last="Kim">Yong-Deok Kim</name>
<affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Corée du Sud</country>
<wicri:regionArea>Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:aff id="A2">Dental Research Institute and Institute of Translational Dental Sciences, Pusan National University, Yangsan, Korea.</nlm:aff>
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<series><title level="j">Journal of the Korean Association of Oral and Maxillofacial Surgeons</title>
<idno type="ISSN">2234-7550</idno>
<idno type="eISSN">2234-5930</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images.</p>
</sec>
<sec><title>Results</title>
<p>No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%.</p>
</sec>
<sec><title>Conclusion</title>
<p>Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Korean Assoc Oral Maxillofac Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">J Korean Assoc Oral Maxillofac Surg</journal-id>
<journal-id journal-id-type="publisher-id">JKAOMS</journal-id>
<journal-title-group><journal-title>Journal of the Korean Association of Oral and Maxillofacial Surgeons</journal-title>
</journal-title-group>
<issn pub-type="ppub">2234-7550</issn>
<issn pub-type="epub">2234-5930</issn>
<publisher><publisher-name>The Korean Association of Oral and Maxillofacial Surgeons</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26568924</article-id>
<article-id pub-id-type="pmc">4641213</article-id>
<article-id pub-id-type="doi">10.5125/jkaoms.2015.41.5.232</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Hyeong-Geun</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Kim</surname>
<given-names>Yong-Deok</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.</aff>
<aff id="A2"><label>2</label>
Dental Research Institute and Institute of Translational Dental Sciences, Pusan National University, Yangsan, Korea.</aff>
<author-notes><corresp>Corresponding author: Yong-Deok Kim. Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. TEL: +82-55-360-5100, FAX: +82-55-360-5104, <email>ydkimdds@pusan.ac.kr</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>20</day>
<month>10</month>
<year>2015</year>
</pub-date>
<volume>41</volume>
<issue>5</issue>
<fpage>232</fpage>
<lpage>239</lpage>
<history><date date-type="received"><day>12</day>
<month>3</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>12</day>
<month>5</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>02</day>
<month>6</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015 The Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Objectives</title>
<p>The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images.</p>
</sec>
<sec><title>Results</title>
<p>No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%.</p>
</sec>
<sec><title>Conclusion</title>
<p>Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.</p>
</sec>
</abstract>
<kwd-group><kwd>Alveolar bone grafting</kwd>
<kwd>Augment bone graft</kwd>
<kwd>Dental implant</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="KR">Pusan National University</funding-source>
</award-group>
</funding-group>
</article-meta>
</front>
<floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label>
<caption><title>A. Cortical bone after sawing targeted bone. B. Donor site after harvesting cortical bone. C. Harvested cortical bone. D. Particulate bone from cortical bone.</title>
</caption>
<graphic xlink:href="jkaoms-41-232-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label>
<caption><title>A. Fixed block bone using the "lag screw" technique. B. Particulate bone surrounding block bone with Tisseel (Baxter Healthcare GmbH, Wien, Austria). C. Membrane materials covering block and particulate bone.</title>
</caption>
<graphic xlink:href="jkaoms-41-232-g002"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float"><label>Fig. 3</label>
<caption><title>A. Evaluating adjacent cortical bone not harvested with the grayscale range. B. Enclosing grafted bone in a rectangular parallelepiped by using an evaluated grayscale range. C. Calculating grafted bone in the Ez3D2009 program (Vatech, Yongin, Korea) setting.</title>
</caption>
<graphic xlink:href="jkaoms-41-232-g003"></graphic>
</fig>
<fig id="F4" orientation="portrait" position="float"><label>Fig. 4</label>
<caption><title>A. Cross-section of grafted bone 1 day after grafting surgery. B. Cross-section of grafted bone 4.2 months after grafting surgery. Hyeong-Geun Lee et al: Volumetric</title>
</caption>
<graphic xlink:href="jkaoms-41-232-g004"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label>
<caption><title>Differences due to grafting direction and location</title>
</caption>
<alternatives><graphic xlink:href="jkaoms-41-232-i001"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="center" rowspan="1" colspan="1">Grafting direction</th>
<th valign="middle" align="center" rowspan="1" colspan="1">No. of recipient sites</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Residual rate (%)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Results in Scheffe's test</th>
<th valign="middle" align="center" rowspan="1" colspan="1"><italic>P</italic>
-value</th>
</tr>
</thead>
<tbody><tr><td valign="middle" align="left" rowspan="1" colspan="1">Direction</td>
<td valign="middle" align="right" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Horizontal</td>
<td valign="middle" align="right" rowspan="1" colspan="1">63</td>
<td valign="middle" align="left" rowspan="1" colspan="1">78.4±6.9</td>
<td valign="middle" align="center" rowspan="1" colspan="1">a</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Vertical</td>
<td valign="middle" align="right" rowspan="1" colspan="1">30</td>
<td valign="middle" align="left" rowspan="1" colspan="1">71.0±5.6</td>
<td valign="middle" align="center" rowspan="1" colspan="1">b</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Horizontal+vertical</td>
<td valign="middle" align="right" rowspan="1" colspan="1">35</td>
<td valign="middle" align="left" rowspan="1" colspan="1">71.0±10.0</td>
<td valign="middle" align="center" rowspan="1" colspan="1">b</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1">Site</td>
<td valign="middle" align="right" rowspan="1" colspan="1"></td>
<td valign="middle" align="left" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Maxilla</td>
<td valign="middle" align="right" rowspan="1" colspan="1">69</td>
<td valign="middle" align="left" rowspan="1" colspan="1">75.6±7.1</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="2" colspan="1">0.154</td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Mandible</td>
<td valign="middle" align="right" rowspan="1" colspan="1">59</td>
<td valign="middle" align="left" rowspan="1" colspan="1">73.4±9.6</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Anterior</td>
<td valign="middle" align="right" rowspan="1" colspan="1">27</td>
<td valign="middle" align="left" rowspan="1" colspan="1">79.5±6.7</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
<td valign="middle" align="center" rowspan="2" colspan="1">0.001</td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1"> Posterior</td>
<td valign="middle" align="right" rowspan="1" colspan="1">101</td>
<td valign="middle" align="left" rowspan="1" colspan="1">73.3±7.1</td>
<td valign="middle" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn><p>The difference between 'a' and 'b' was statistically significant in Scheffe's test.</p>
<p>Statistical significance level, <italic>P</italic>
<0.05</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" orientation="portrait" position="float"><label>Table 2</label>
<caption><title>Differences due to age and sex</title>
</caption>
<alternatives><graphic xlink:href="jkaoms-41-232-i002"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="left" rowspan="1" colspan="1">Variable</th>
<th valign="middle" align="center" rowspan="1" colspan="1">No. of recipient sites</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Residual rate (%)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Results in Scheffe's test</th>
<th valign="middle" align="center" rowspan="1" colspan="1"><italic>P</italic>
-value</th>
</tr>
</thead>
<tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">Age (yr)</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> ≤19</td>
<td valign="top" align="right" rowspan="1" colspan="1">2</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 20-29</td>
<td valign="top" align="right" rowspan="1" colspan="1">8</td>
<td valign="top" align="center" rowspan="1" colspan="1">77.6±8.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">a, b</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 30-39</td>
<td valign="top" align="right" rowspan="1" colspan="1">15</td>
<td valign="top" align="center" rowspan="1" colspan="1">81.0±6.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">b</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 40-49</td>
<td valign="top" align="right" rowspan="1" colspan="1">28</td>
<td valign="top" align="center" rowspan="1" colspan="1">76.4±7.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">a, b</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 50-59</td>
<td valign="top" align="right" rowspan="1" colspan="1">50</td>
<td valign="top" align="center" rowspan="1" colspan="1">71.5±8.8</td>
<td valign="top" align="center" rowspan="1" colspan="1">a</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 60-69</td>
<td valign="top" align="right" rowspan="1" colspan="1">23</td>
<td valign="top" align="center" rowspan="1" colspan="1">73.6±6.7</td>
<td valign="top" align="center" rowspan="1" colspan="1">a, b</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> 70-79</td>
<td valign="top" align="right" rowspan="1" colspan="1">2</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1">-</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> Total</td>
<td valign="top" align="right" rowspan="1" colspan="1">128</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1">Sex</td>
<td valign="top" align="right" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="4" colspan="1">0.148</td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> Male</td>
<td valign="top" align="right" rowspan="1" colspan="1">62</td>
<td valign="top" align="center" rowspan="1" colspan="1">73.3±8.9</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> Female</td>
<td valign="top" align="right" rowspan="1" colspan="1">66</td>
<td valign="top" align="center" rowspan="1" colspan="1">75.8±7.8</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr><td valign="top" align="left" rowspan="1" colspan="1"> Total</td>
<td valign="top" align="right" rowspan="1" colspan="1">128</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn><p>In Scheffe's test, the difference between 'a' and 'a, b', and 'b' and 'a, b', were not statistically significant; however, the difference between 'a' and 'b' was statistically significant.</p>
<p>Statistical significance level, <italic>P</italic>
<0.05</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" orientation="portrait" position="float"><label>Table 3</label>
<caption><title>Differences due to whether or not the sinus lift procedure was conducted</title>
</caption>
<alternatives><graphic xlink:href="jkaoms-41-232-i003"></graphic>
<table frame="hsides" rules="rows"><thead><tr><th valign="top" align="center" rowspan="1" colspan="1">Sinus lift</th>
<th valign="top" align="center" rowspan="1" colspan="1">Site (n)</th>
<th valign="top" align="center" rowspan="1" colspan="1">Residual rate (%)</th>
<th valign="top" align="center" rowspan="1" colspan="1"><italic>P</italic>
-value</th>
</tr>
</thead>
<tbody><tr><td valign="middle" align="left" rowspan="1" colspan="1">With sinus lift</td>
<td valign="middle" align="center" rowspan="1" colspan="1">22</td>
<td valign="middle" align="center" rowspan="1" colspan="1">72.3±6.1</td>
<td valign="middle" align="center" rowspan="2" colspan="1">0.21</td>
</tr>
<tr><td valign="middle" align="left" rowspan="1" colspan="1">Without sinus lift</td>
<td valign="middle" align="center" rowspan="1" colspan="1">25</td>
<td valign="middle" align="center" rowspan="1" colspan="1">74.7±6.6</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot><fn><p>Statistical significance level, <italic>P</italic>
<0.05</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>
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