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Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients with Unilateral Cleft Lip and Palate.
Plast Reconstr Surg 2016; 137(1):218-27PR

Abstract

BACKGROUND

The role of primary gingivoperiosteoplasty in the repair of alveolar clefts remains controversial. The aim of this study was to compare the outcomes of primary gingivoperiosteoplasty and secondary alveolar bone grafting in patients with unilateral cleft lip and palate.

METHODS

In this prospective study, the authors analyzed the postoperative cone-beam computed tomographic scans of 50 children with complete unilateral cleft lip and palate who underwent primary gingivoperiosteoplasty (n = 25) or secondary alveolar bone grafting (n = 25). These two methods of alveolar repair were compared by measuring residual cleft defect and unsupported root ratio of cleft-adjacent central incisors on patient scans.

RESULTS

Patients who underwent repair by primary gingivoperiosteoplasty presented more need for additional bone grafting than those undergoing repair by secondary alveolar bone grafting (28 percent versus 4 percent, respectively; p < 0.05). Residual cleft defect was greater in patients who underwent repair by primary gingivoperiosteoplasty than by secondary alveolar bone grafting (305.8 ± 176.5 mm versus 178.6 ± 122.0 mm, respectively; p < 0.05). Patients who underwent repair by primary gingivoperiosteoplasty showed more residual palatal coronal and palatal apical defects than those who underwent repair by secondary alveolar bone grafting (p < 0.05 and p < 0.001, respectively).

CONCLUSIONS

In patients with unilateral cleft lip and palate, primary gingivoperiosteoplasty can achieve 72 percent success. Primary gingivoperiosteoplasty results in less bone than secondary alveolar bone grafting, particularly on the palatal apical portion of the previous alveolar cleft. Clinical success is lower with primary gingivoperiosteoplasty than with secondary alveolar bone grafting.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, III.

Authors+Show Affiliations

Taipei, Taoyuan, and Linkou, Taiwan From the Department of Craniofacial Orthodontics, the Craniofacial Center, the Craniofacial Research Center, and the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital; and the College of Medicine, Chang Gung University.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26710026

Citation

Wang, Yi-Chin, et al. "Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate." Plastic and Reconstructive Surgery, vol. 137, no. 1, 2016, pp. 218-27.
Wang YC, Liao YF, Chen PK. Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients with Unilateral Cleft Lip and Palate. Plast Reconstr Surg. 2016;137(1):218-27.
Wang, Y. C., Liao, Y. F., & Chen, P. K. (2016). Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients with Unilateral Cleft Lip and Palate. Plastic and Reconstructive Surgery, 137(1), pp. 218-27. doi:10.1097/PRS.0000000000001897.
Wang YC, Liao YF, Chen PK. Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate. Plast Reconstr Surg. 2016;137(1):218-27. PubMed PMID: 26710026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative Outcomes of Primary Gingivoperiosteoplasty and Secondary Alveolar Bone Grafting in Patients with Unilateral Cleft Lip and Palate. AU - Wang,Yi-Chin, AU - Liao,Yu-Fang, AU - Chen,Philip Kuo-Ting, PY - 2015/12/29/entrez PY - 2015/12/29/pubmed PY - 2016/5/7/medline SP - 218 EP - 27 JF - Plastic and reconstructive surgery JO - Plast. Reconstr. Surg. VL - 137 IS - 1 N2 - BACKGROUND: The role of primary gingivoperiosteoplasty in the repair of alveolar clefts remains controversial. The aim of this study was to compare the outcomes of primary gingivoperiosteoplasty and secondary alveolar bone grafting in patients with unilateral cleft lip and palate. METHODS: In this prospective study, the authors analyzed the postoperative cone-beam computed tomographic scans of 50 children with complete unilateral cleft lip and palate who underwent primary gingivoperiosteoplasty (n = 25) or secondary alveolar bone grafting (n = 25). These two methods of alveolar repair were compared by measuring residual cleft defect and unsupported root ratio of cleft-adjacent central incisors on patient scans. RESULTS: Patients who underwent repair by primary gingivoperiosteoplasty presented more need for additional bone grafting than those undergoing repair by secondary alveolar bone grafting (28 percent versus 4 percent, respectively; p < 0.05). Residual cleft defect was greater in patients who underwent repair by primary gingivoperiosteoplasty than by secondary alveolar bone grafting (305.8 ± 176.5 mm versus 178.6 ± 122.0 mm, respectively; p < 0.05). Patients who underwent repair by primary gingivoperiosteoplasty showed more residual palatal coronal and palatal apical defects than those who underwent repair by secondary alveolar bone grafting (p < 0.05 and p < 0.001, respectively). CONCLUSIONS: In patients with unilateral cleft lip and palate, primary gingivoperiosteoplasty can achieve 72 percent success. Primary gingivoperiosteoplasty results in less bone than secondary alveolar bone grafting, particularly on the palatal apical portion of the previous alveolar cleft. Clinical success is lower with primary gingivoperiosteoplasty than with secondary alveolar bone grafting. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. SN - 1529-4242 UR - https://www.unboundmedicine.com/medline/citation/26710026/Comparative_Outcomes_of_Primary_Gingivoperiosteoplasty_and_Secondary_Alveolar_Bone_Grafting_in_Patients_with_Unilateral_Cleft_Lip_and_Palate_ L2 - http://Insights.ovid.com/pubmed?pmid=26710026 DB - PRIME DP - Unbound Medicine ER -