Calvarial periosteal graft for second-stage cleft palate surgery: A preliminary report

Neiva, Cláudia Lopes Santoro; Dakpe, Stéphanie; Gbaguidi, C.; Testelin, Sylvie; Devauchelle, Bernard

doi:10.1016/j.jcms.2013.07.007

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…[25] The surgeon's expertise and skill in performing a given technique and thus achieving better outcomes seems to be a key factor in the maxillary growth outcome. In this study, we evaluated the alterations of the maxillary arches of neonates submitted to early cheiloplasty and palatoplasty at 3 and 12 months of age, respectively, through two different techniques.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

Carrara

Ambrosio

Mello

et al. 2016

Ann Maxillofac Surg

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Background:Individuals with cleft lip and palate have many anatomic and functional alterations compromising esthetics, hearing, speech, occlusion, and development/craniofacial growth. The rehabilitative treatment of these patients is very challenging and starts at birth aiming at the best treatment for all functional demands. This study aimed to evaluate the dimensional alterations of the dental arches of neonates with cleft lip and palate after two different primary surgical techniques.Materials and Methods:The sample comprised 114 digital models of children aged from 3 to 36 months, with unilateral complete cleft lip and palate divided into two groups. Two different phases were evaluated: precheiloplasty and 1 year after palatoplasty. The evaluation was performed through the digital models of each child obtained by scanning digitalization (3D Scanner). Dental arches measurements were accomplished through Appliance Designer software. The following measurements were assessed: dental arch area, anterior amplitude of the cleft, total length of dental arch, intercanine distance, and intertuberosity distance. t-test was applied to compare differences between groups.Results:No statistically significant differences were observed between groups at precheiloplasty phase. At 1 year after palatoplasty, the groups differed in the total length of dental arch (P = 0.002), with greater values for Group I.Conclusion:This study suggests that the results of the different surgical techniques may alter the growth and development of the dental arches of neonates with cleft lip and palate.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

Carrara

Ambrosio

Mello

et al. 2016

Ann Maxillofac Surg

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“…The second principle involves detaching the oral tissue and shifting it over the cleft area while creating an open wound that heals outside the cleft area from where the tissue has been detached [28][29][30]. In the third principle, tissue from outside the palatal area is used to cover the open wound areas that result from the first or second technique [31][32][33][34]. While all of these surgical techniques are able to close the cleft gap using the available tissue, none of them result in the generation of new mucoperiosteal tissue.…”

Section: Introductionmentioning

confidence: 99%

Load Transfer during Magnetic Mucoperiosteal Distraction in Newborns with Complete Unilateral and Bilateral Orofacial Clefts: A Three-Dimensional Finite Element Analysis

et al. 2020

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The primary correction of congenital complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) is challenging due to inherent lack of palatal tissue and small extent of the palatal shelves at birth. The tissue deficiency affects the nasal mucosa, maxillary bone and palatal mucosa. This condition has driven the evolution of several surgical and non-surgical techniques for mitigating the inherent problem of anatomical deficits. These techniques share the common principle of altering the neighboring tissues around the defect area in order to form a functional seal between the oral and nasal cavity. However, there is currently no option for rectifying the tissue deficiency itself. Investigations have repeatedly shown that despite the structural tissue deficiency of the cleft, craniofacial growth proceeds normal if the clefts remain untreated, but the cleft remains wide. Conversely, craniofacial growth is reduced after surgical repair and the related alteration of the tissues. Therefore, numerous attempts have been made to change the surgical technique and timing so as to reduce the effects of surgical repairs on craniofacial growth, but they have been only minimally effective so far. We have determined whether the intrinsic structural soft and hard tissue deficiency can be ameliorated before surgical repair using the principles of periosteal distraction by means of magnetic traction. Two three-dimensional maxillary finite element models, with cleft patterns of UCLP and BCLP, respectively, were created from computed tomography slice data using dedicated image analysis software. A virtual dental magnet was positioned on either side of the cleft at the mucoperiosteal borders, and an incremental magnetic attraction force of up to 5 N was applied to simulate periosteal distraction. The stresses and strains in the periosteal tissue induced by the magnet were calculated using finite element analysis. For a 1 N attraction force the maximum strains did not exceed 1500 µstrain suggesting that adaptive remodeling will not take place for attraction forces lower than 1 N. At 5 N the regions subject to remodeling differed between the UCLP and BCLP models. Stresses and strains at the periosteum of the palatal shelf ridges in the absence of compressive forces at the alveolar borders were greater in the UCLP model than the BCLP model. The findings suggest that in newborns with UCLP and BCLP, periosteal distraction by means of a magnetic 5 N attraction force can promote the generation of soft and hard tissues along the cleft edges and rectify the tissue deficiency associated with the malformation.

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“…Pedicled periosteum and a demineralized bone matrix scaffold can prefabricate bone graft with higher osteo-inductive angio-inductive properties and increase biomechanical properties compared to the muscular pouch strategy 10 . At present, autologous periosteal transplantation is relatively mature in animal models, and some explorations have also been carried out in clinical operations [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . Du et al 11 found that acetabuloplasty with autologous tibial periosteal transplantation might be a promising and effective adjunctive treatment for hip articular cartilage defects.…”

Section: Autologous Periosteal Transplantationmentioning

confidence: 99%

“…Pedicled periosteum and a demineralized bone matrix scaffold can prefabricate bone graft with higher osteo‐inductive angio‐inductive properties and increase biomechanical properties compared to the muscular pouch strategy 10 . At present, autologous periosteal transplantation is relatively mature in animal models, and some explorations have also been carried out in clinical operations 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 . Du et al .…”

Section: Periosteal Osteogenesis In Vivomentioning

confidence: 99%

Progress of Periosteal Osteogenesis: The Prospect of In Vivo Bioreactor

Chen

Wang

et al. 2022

Orthopaedic Surgery

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Repairing large segment bone defects is still a clinical challenge. Bone tissue prefabrication shows great translational potentials and has been gradually accepted clinically. Existing bone reconstruction strategies, including autologous periosteal graft, allogeneic periosteal transplantation, xenogeneic periosteal transplantation, and periosteal cell tissue engineering, are all clinically valuable treatments and have made significant progress in research. Herein, we reviewed the research progress of these techniques and briefly explained the relationship among in vivo microenvironment, mechanical force, and periosteum osteogenesis. Moreover, we also highlighted the importance of the critical role of periosteum in osteogenesis and explained current challenges and future perspective.

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Calvarial periosteal graft for second-stage cleft palate surgery: A preliminary report

Cited by 9 publications

References 27 publications

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft

Load Transfer during Magnetic Mucoperiosteal Distraction in Newborns with Complete Unilateral and Bilateral Orofacial Clefts: A Three-Dimensional Finite Element Analysis

Progress of Periosteal Osteogenesis: The Prospect of In Vivo Bioreactor

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