Evaluation of Bone Regeneration in Single Stage Closure of Cleft Alveolus with Gingivoperiosteoplasty

Abstract

Background: Cleft alveolus closure is a challenge for cleft surgeon for many decades. Secondary alveolar bone grafting (SABG) is the preferred technique using autologous cancellous ileac crest bone as the donor graft. Many alternative methods were tried over the years with no any promising results. Gingivoperiosteoplasty (GPP) is a good alternative surgical technique for bone regeneration in cleft alveolus with proper case selection criteria. Aim: Aim of the study was to evaluate the bone regeneration following closure of cleft alveolus with gingivoperiosteoplasty. Method: This study was carried out in the department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India, from March 2018 to July 2019. In this study, we have performed gingivoperiosteoplasty with palatoplasty and evaluated the amount of bone formation in the cleft alveolus using a series of intra oral periapical radiographs. Five patients who required surgical repair of unilateral cleft palate and alveolus were selected for the study. Clinical and radiographical assessment was done post operatively, after three and six months respectively for anatomical function and bone formation. Results: After completion of clinical studies on patients, the statistical analysis of the data obtained. Radiographs were analyzed for grey scale density by means of adobe photo shop using the MATLAB process by histogram comparison in three months and six months, showing denser grey scale pattern, indicating the new bone formation in the cleft alveolus surgical site, in all the 5 surgical cases. Conclusion: Gingivoperiosteoplasty (GPP) is a good alternative procedure to secondary alveolar bone grafting (SABG), so donor site morbidity can be avoided with reduced time and cost for the surgery. But a larger sample size and longer follow-up are necessary to understand the better reliability of this surgical technique. Clinical Significance: Gingivoperiosteoplasty in cleft alveolus patients showed significant bone formation in 3 to 6 months postoperatively.