The use of periosteum and Surgicel for bone restoration in congenital clefts of the maxilla. A clinical report and experimental investigation.

Abstract

New principles are introduced for the primary repair of the maxilla in congenital cleft deformities, founded on the assumption that periosteum and bone bordering the cleft possesses normal growth potential. By periosteum to periosteum apposition all around the cleft new bone was formed. In complete clefts continuity between the segments was achieved, the premaxilla became firmly consolidated into the arch, maxillary collapse was prevented, and there was a favourable approximation within the alveolar region. Over denuded bone complete periosteal regeneration took place and appositional growth of the lateral segment was promoted.To obtain a larger volume of bone by periostealplasty it proved necessary to keep the flaps suitably separated. In maintaining the periosteal membranes in the desired position Surgicel® provided a useful scaffolding. Animal experiments demonstrated that this hemostatic material can be safely used for subperiosteal implantation. This procedure will lead to the formation of cancellous...