Extensive Gingivoperiosteoplasty Versus Secondary Alveolar Bone Grafting in Patients With Complete Bilateral Cleft Lip and Palate During the Mixed Dentition Period

Lu, Ting-Chen; Bhandari, Kishor; Yao, Chuan-Fong; Tangco, Ivy; Bajracharya, Manish; Chen, Philip Kuo-Ting

doi:10.1097/sap.0000000000003118

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…The success rate of ABG greatly varies, ranging from 52 to 95%, depending on the institutions and their criteria 101 – 103 . In this study, secondary ABG or GPP was performed more than once in 43 patients (35.2%) 104 . In our current protocol, one-stage secondary ABG using iliac cancellous bone is performed.…”

Section: Discussionmentioning

confidence: 96%

Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study

Hattori

Pai

Saito

et al. 2023

International Journal of Surgery

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Background: Patients with cleft lip and palate have functional and esthetic impairment and typically require multiple interventions in their life. Long-term evaluation following a treatment protocol, especially for patients with complete bilateral cleft lip and palate (BCLP), is important but was rarely reported in the literature. Patients and methods: A retrospective review was conducted on all patients with complete BCLP born between 1995 and 2002 and treated at our center. Inclusion criteria were having adequate medical records and receiving continuous multidisciplinary team care at least until 20 years of age. Exclusion criteria were lack of regular follow-up and congenital syndromic abnormalities. The medical records and photos were reviewed, and facial bone development was evaluated using cephalometric analysis. Results: A total of 122 patients were included, with a mean age of 22.1 years at the final evaluation in this study. Primary one-stage cheiloplasty was performed in 91.0% of the patients, and 9.0% underwent two-stage repair with an initial adhesion cheiloplasty. All patients underwent two-flap palatoplasty at an average of 12.3 months. Surgical intervention for velopharyngeal insufficiency was required in 59.0% of patients. Revisional lip/nose surgery was performed in 31.1% during growing age and in 64.8% after skeletal maturity. Orthognathic surgery was applied in 60.7% of patients with retruded midface, of which 97.3% underwent two-jaw surgery. The average number of operations to complete the treatment was 5.9 per patient. Conclusion: Patients with complete BCLP remain the most challenging group to treat among the cleft. This review revealed certain suboptimal results, and modifications have been made to the treatment protocol. Longitudinal follow-up and periodic assessment help to establish an ideal therapeutic strategy and improve overall cleft care.

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Section: Discussionmentioning

confidence: 96%

Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study

Hattori

Pai

Saito

et al. 2023

International Journal of Surgery

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Gingivoperiosteoplasty in Children with Cleft Lip and Palate: The Need for Alveolar Bone Grafting

Balumuka,

Daly,

Krakauer

et al. 2024

The Cleft Palate Craniofacial Journal

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Objective This study aimed to determine the efficacy of gingivoperiosteoplasty (GPP) in preventing alveolar bone grafting (ABG) among children with cleft lip and palate (CLP). Design/Setting Retrospective university hospital single center study. Patients Children with CLP treated with GPP from 2000-2015 were included. Those under eight years of age, without definitive conclusions regarding need for ABG or with incomplete data were excluded. Interventions Included patients were analyzed for demographics, cleft type, age at GPP, associated cleft surgery, use of nasoalveolar molding (NAM), indication for ABG, operating surgeon and presence of residual alveolar fistula. T-tests and Fisher's exact tests were utilized for statistical analysis. Main Outcome Measure The need for ABG. Results Of the 1682 children identified with CLP, 64 underwent GPP and met inclusion criteria. 78% of patients with CLP who underwent GPP were recommended for ABG. Those who received GPP at a younger age ( P = .004) and at the time of initial cleft lip repair ( P = .022) were less likely to be recommended for ABG. Patients with complete CLP were more likely to be recommended for ABG than patients with cleft lip and alveolus only ( P = .015). The operating surgeon impacted the likelihood of ABG ( P = .004). Patient gender, race, ethnicity, laterality, and NAM were not significantly associated with recommendation for ABG. Conclusion GPP does not preclude the need for ABG. Therefore, the success of ABG after GPP and maxillary growth restriction should be analyzed further to determine if GPP is a worthwhile adjunct to ABG in cleft care.

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Extensive Gingivoperiosteoplasty Versus Secondary Alveolar Bone Grafting in Patients With Complete Bilateral Cleft Lip and Palate During the Mixed Dentition Period

Cited by 2 publications

References 27 publications

Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study

Long-term treatment outcome of patients with complete bilateral cleft lip and palate: a retrospective cohort study

Gingivoperiosteoplasty in Children with Cleft Lip and Palate: The Need for Alveolar Bone Grafting

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