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Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty.
Cleft Palate Craniofac J 1998; 35(1):77-80CP

Abstract

OBJECTIVE

The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure.

DESIGN

This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition.

SETTING

This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team.

PATIENTS

All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period.

INTERVENTIONS

Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP.

MAIN OUTCOME MEASURES

The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP.

RESULTS

Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts.

CONCLUSIONS

In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition.

Authors+Show Affiliations

Department of Orthodontics, University of Puerto Rico School of Dentistry, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9482227

Citation

Santiago, P E., et al. "Reduced Need for Alveolar Bone Grafting By Presurgical Orthopedics and Primary Gingivoperiosteoplasty." The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, vol. 35, no. 1, 1998, pp. 77-80.
Santiago PE, Grayson BH, Cutting CB, et al. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998;35(1):77-80.
Santiago, P. E., Grayson, B. H., Cutting, C. B., Gianoutsos, M. P., Brecht, L. E., & Kwon, S. M. (1998). Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 35(1), pp. 77-80.
Santiago PE, et al. Reduced Need for Alveolar Bone Grafting By Presurgical Orthopedics and Primary Gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998;35(1):77-80. PubMed PMID: 9482227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. AU - Santiago,P E, AU - Grayson,B H, AU - Cutting,C B, AU - Gianoutsos,M P, AU - Brecht,L E, AU - Kwon,S M, PY - 1998/3/3/pubmed PY - 1998/3/3/medline PY - 1998/3/3/entrez SP - 77 EP - 80 JF - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association JO - Cleft Palate Craniofac. J. VL - 35 IS - 1 N2 - OBJECTIVE: The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure. DESIGN: This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition. SETTING: This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team. PATIENTS: All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period. INTERVENTIONS: Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP. MAIN OUTCOME MEASURES: The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP. RESULTS: Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts. CONCLUSIONS: In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition. SN - 1055-6656 UR - https://www.unboundmedicine.com/medline/citation/9482227/Reduced_need_for_alveolar_bone_grafting_by_presurgical_orthopedics_and_primary_gingivoperiosteoplasty_ L2 - http://journals.sagepub.com/doi/full/10.1597/1545-1569_1998_035_0077_rnfabg_2.3.co_2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -