Supraperiosteal Flap Technique Versus Mucoperiosteal Flap Technique in Cleft Palate Surgery

Abstract

Recent animal experiments have shown that palatal repair without denudation of bone leads to a superior dento-alveolar development. The aim of this clinical study was to evaluate the peri- and postoperative course and the dento-alveolar development of the deciduous dentition in Japanese ULCP, and CP patients up to 5 years after two different types of palatal repair. One of the methods, the Kohama (1991) supraperiosteal flap technique, is performed without denudation of the bony palate, while the other, the Wardill (1937) push-back technique, results in areas of denuded bone. It was concluded that the supraperiosteal technique can be performed successfully in approximately the same amount of time as the push-back technique. Re-epithelialization of the wound areas after supraperiosteal repair takes about 1 week, which is one third of the time associated with healing after the push-back technique. Arch depth of the deciduous dentition after the supraperiosteal technique is superior compared to the push-back technique. The question of whether or not the supraperiosteal technique produces more favorable dento-alveolar development than the mucoperiosteal technique in the permanent dentition in humans has to be elucidated in future research.

Cleft palate repair and variations

“…[29] Variations There are sporadic reports on variations of palatoplasty techniques. To mention a few: • Bumsted's two-layer closure of palate in very wide cleft palate [30] • Widmaier-Perko Palatoplasty [31] • Supraperiosteal dissection of flap in the region of hard palate instead of mucoperiosteal flap [32] This dissection has been advocated so as to minimize the maxillary hypoplasia, however, the surgical dissection in the submucosal plane is bloody, difficult and timeconsuming. • Osada's two-stage palatoplasty [33] • Frolova primary palatoplasty technique [34] • Anterior mucoperiosteal hinge for nasal lining in partial cleft palate [35] • Marginal musculo-mucosal flap [36] These are some of the variations and procedures which are being performed by a specific surgeon or in a specific centre.…”

Unilateral Palatal Hypoplasia: A Case Report With a Long-Term Follow-Up

“…Incisions in the affected side of the hard and soft palate were made as with the pushback method in our institute. A partially split muco-periosteal flap, with its distal end used as a mucosal flap, was elevated onto the affected side of palate (Leenstra et al, 1996). As a result, the periosteum was left in the resulting mucosal defect area on the palatal bone posterior to the alveolar region, over an area measuring approximately 7 mm in width.…”

Bilateral cleft lip and palate. Maxillofacial growth and dental development

“…They aim to diminish the formation of scar tissue in order to reduce the growth retardation of the maxilla and the collapse of the maxillary dental arch (Leenstra et al, 1995(Leenstra et al, , 1996Van Damme et al, 1997).…”