Clinical outcomes of gingivoperiosteoplasty for unilateral cleft lip and palate performed in early childhood

Abstract

Conventional gingivoperiosteoplasty (GPP) performed during infancy adversely affects maxillary development. However, the outcomes of this procedure in early childhood have rarely been reported. Therefore, we examined the postoperative outcomes of GPP conducted in patients aged 1.5 years with unilateral cleft lip and palate (UCLP).This study included 87 non-syndromic patients with complete UCLP who had undergone early two-stage palatoplasty during the 1999–2004 period. The protocol comprised soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age. In the GPP group (n=34), we introduced the GPP procedure during hard palate closure; in the non-GPP group (n=53), the labial side of the alveolar cleft remained intact. We examined computed tomography images taken at 8 years of age to observe bone formation at the alveolar cleft site. We also conducted cephalometric analysis to examine maxillary development at 12 years of age.Bone bridges at the alveolar cleft site were observed in 92% and 5.6% of the GPP and non-GPP groups, respectively. Moreover, 59% of the GPP group did not require secondary alveolar bone grafting (sABG), whereas all the patients in the non-GPP group underwent sABG. No statistically significant differences were noted in the maxillary anteroposterior length (GPP: 45.5±3.7mm, non-GPP: 45.9±3.5mm, p=0.67) and sella–nasion–point A angle (GPP: 75.6±4.5°, non-GPP: 73.8±12.6°, p=0.49).This study’s findings suggest that GPP performed at 1.5 years of age minimises the necessity of sABG and does not exert a negative influence on maxillofacial development.