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Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts.
Plast Reconstr Surg 1999; 103(6):1630-44PR

Abstract

Comparing the treatment protocols for cleft lip and palate requires a study of facial growth and development. Serial orthodontic study models aid in delineating the effects of surgery on maxillary mandibular relationships. In 1978, a new protocol, POPLA (presurgical orthopedics followed by periosteoplasty and lip adhesion), was developed and put into practice. This article compares the results obtained using POPLA (group I) with those using the previous method (lip adhesion alone) (group II) for cases of unilateral and bilateral clefts. Complete orthodontic study models were available for 124 patients, 63 in group I and 61 in group II. Specific timing sequences and surgical details are discussed. Dental cast analyses evaluated alveolar gap, arch width, anteroposterior distance, incisor crossbite (single tooth and multiple tooth), and buccal crossbite (single and multiple tooth) at birth and at 3, 6, and 9 years of age. X-ray studies evaluated the bony bridge. Additional comments are made regarding the incidents and effects of pharyngeal flaps and bone grafts on maxillary-mandibular relationships. Results included less buccal crossbite in the POPLA group, with a wider transverse distance of the upper dental arch. There was a greater frequency of anterior crossbite in the POPLA group, and the anteroposterior distance was shorter at 6 years of age but less so by age 9. This may be because of the different orthodontic care received by the patients in the two groups. In conclusion, the POPLA approach achieves the main goal of moving the palate into a normal position and stabilizing the arch with a bony bridge that attracts teeth. It avoids the difficult anterior fistulae and presents a more symmetrical platform upon which the lip can be united and the nose can be corrected early.

Authors+Show Affiliations

University of Miami School of Medicine, Fla, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10323695

Citation

Millard, D R., et al. "Cleft Lip and Palate Treated By Presurgical Orthopedics, Gingivoperiosteoplasty, and Lip Adhesion (POPLA) Compared With Previous Lip Adhesion Method: a Preliminary Study of Serial Dental Casts." Plastic and Reconstructive Surgery, vol. 103, no. 6, 1999, pp. 1630-44.
Millard DR, Latham R, Huifen X, et al. Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plast Reconstr Surg. 1999;103(6):1630-44.
Millard, D. R., Latham, R., Huifen, X., Spiro, S., & Morovic, C. (1999). Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plastic and Reconstructive Surgery, 103(6), pp. 1630-44.
Millard DR, et al. Cleft Lip and Palate Treated By Presurgical Orthopedics, Gingivoperiosteoplasty, and Lip Adhesion (POPLA) Compared With Previous Lip Adhesion Method: a Preliminary Study of Serial Dental Casts. Plast Reconstr Surg. 1999;103(6):1630-44. PubMed PMID: 10323695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. AU - Millard,D R, AU - Latham,R, AU - Huifen,X, AU - Spiro,S, AU - Morovic,C, PY - 1999/5/14/pubmed PY - 1999/5/14/medline PY - 1999/5/14/entrez SP - 1630 EP - 44 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 103 IS - 6 N2 - Comparing the treatment protocols for cleft lip and palate requires a study of facial growth and development. Serial orthodontic study models aid in delineating the effects of surgery on maxillary mandibular relationships. In 1978, a new protocol, POPLA (presurgical orthopedics followed by periosteoplasty and lip adhesion), was developed and put into practice. This article compares the results obtained using POPLA (group I) with those using the previous method (lip adhesion alone) (group II) for cases of unilateral and bilateral clefts. Complete orthodontic study models were available for 124 patients, 63 in group I and 61 in group II. Specific timing sequences and surgical details are discussed. Dental cast analyses evaluated alveolar gap, arch width, anteroposterior distance, incisor crossbite (single tooth and multiple tooth), and buccal crossbite (single and multiple tooth) at birth and at 3, 6, and 9 years of age. X-ray studies evaluated the bony bridge. Additional comments are made regarding the incidents and effects of pharyngeal flaps and bone grafts on maxillary-mandibular relationships. Results included less buccal crossbite in the POPLA group, with a wider transverse distance of the upper dental arch. There was a greater frequency of anterior crossbite in the POPLA group, and the anteroposterior distance was shorter at 6 years of age but less so by age 9. This may be because of the different orthodontic care received by the patients in the two groups. In conclusion, the POPLA approach achieves the main goal of moving the palate into a normal position and stabilizing the arch with a bony bridge that attracts teeth. It avoids the difficult anterior fistulae and presents a more symmetrical platform upon which the lip can be united and the nose can be corrected early. SN - 0032-1052 UR - https://www.unboundmedicine.com/medline/citation/10323695/Cleft_lip_and_palate_treated_by_presurgical_orthopedics_gingivoperiosteoplasty_and_lip_adhesion__POPLA__compared_with_previous_lip_adhesion_method:_a_preliminary_study_of_serial_dental_casts_ L2 - http://Insights.ovid.com/pubmed?pmid=10323695 DB - PRIME DP - Unbound Medicine ER -