Tomographic Assessment of Bone Formation After the Collares Technique of Gingivoperiosteoplasty in Patients With Cleft Lip and Palate

Cleft Palate Craniofac J. 2016 Jan;53(1):47-56. doi: 10.1597/14-089. Epub 2015 May 7.

Abstract

Objectives: This cross-sectional study sought to assess bone formation and spontaneous tooth eruption in a cohort of 25 consecutive patients aged 6 to 11 years who underwent primary gingivoperiosteoplasty by the Collares technique.

Design: Cross-sectional study assessing bone formation in the cleft area using a within-group time series design.

Setting: Hospital de Clínicas de Porto Alegre (HCPA), a tertiary hospital in Brazil.

Patients: Twenty-five patients with nonsyndromic, complete unilateral cleft lip and palate, no comorbidities, and unerupted permanent canines.

Intervention: Cheiloplasty was performed by means of the Millard II technique, with the addition of a triangle at the mucocutaneous junction, vomer flap nasal floor closure, and wide subperiosteal elevation, followed by gingivoperiosteoplasty by the Collares technique.

Main outcome measures: Cone-beam computed tomography was used to assess treatment effect. In a novel method, software was used to obtain two three-dimensional reconstructions, one each of the cleft and noncleft sides, enabling quantitative comparison of bone presence in the alveolar defect area.

Results: Of the 25 patients, 24 achieved bone bridge formation. The cleft side had 75.1% (67.9%-82.3%) of the bone volume, 70.5% (53.1%-87.9%) of the height, and 63.3% (44.1%-82.5%) of the width of the noncleft side. Bone formation was 17.28% lower in patients with lateral incisor agenesis.

Conclusion: Collares gingivoperiosteoplasty performed well as a technique for alveolar repair in patients with cleft lip and palate, allowing spontaneous eruption of deciduous and permanent lateral incisors through the bone bridge created.

Keywords: cleft lip and palate; cone beam computed tomography; gingivoperiosteoplasty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Process / diagnostic imaging*
  • Alveolar Process / surgery*
  • Brazil
  • Child
  • Cleft Lip / diagnostic imaging*
  • Cleft Lip / surgery*
  • Cleft Palate / diagnostic imaging*
  • Cleft Palate / surgery*
  • Cone-Beam Computed Tomography*
  • Cross-Sectional Studies
  • Female
  • Gingivoplasty / methods*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional
  • Male
  • Osteogenesis
  • Periosteum / surgery*
  • Surgical Flaps
  • Tooth Eruption
  • Treatment Outcome