Evaluation of Clinical Outcomes of Primary Gingivoperiosteoplasty in Patients with Unilateral Clefts

Abstract

Background:There are two standard methods to reconstruct the alveolar cleft in unilateral cleft patients. The first method is bone grafting and the second is primary gingivoperiosteoplasty (GPP). Even today, the debate over which method is superior continues. Aim and Objectives:This study was designed to retrospectively evaluate the clinical outcomes of primary gingivoperiosteoplasty in patients with unilateral clefts. Materials and Methods:Retrospectively, 44 unilateral complete cleft lip/palate patients were collected from Dec. 1999 to Dec. 2001 at Chang Gung memorial Hospital. All patients underwent naso-alveolar molding prior to lip repair in order to align and approximate the maxillary segments. They all underwent primary gingivoperiosteoplasty at the time of primary lip repair around the age of 3 months. A minimum of 10 year follow-up, including X-ray images with periapical and occlusal views, is available for all patients. The Bergland Scale was used to measure the quantity of bone formation at the site of the alveolar cleft. Results:As per the Bergland Scale, 3 patients were classified as type I, 27 patients were classified as type II, 10 patients were classified as type III, and 4 patients were classified as type IV. Bergland type I (3) and Bergland type II (27) signify adequate bone formation with no need for additional alveolar bone grafting. The successful bone formation rate was 30/44 (68.2%), and the inadequate bone production rate was 14/44 (31.8%). Conclusion:Primary GPP can decrease the proportion of patients requiring secondary bone grafting, prevent donor site morbidity, and decrease overall operative time.