Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

Yu-Ying Chu; Frank Chun-Shin Chang; Ting-Chen Lu; Che-Hsiung Lee; Philip Kuo-Ting Chen

doi:10.3390/jcm9020576

Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

J Clin Med. 2020 Feb 20;9(2):576. doi: 10.3390/jcm9020576.

Authors

Yu-Ying Chu^{1

2}, Frank Chun-Shin Chang^{2

3}, Ting-Chen Lu², Che-Hsiung Lee^{1

2}, Philip Kuo-Ting Chen⁴

Affiliations

¹ Division of Trauma Plastic Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial hospital, Linkou 333, Taiwan.
² Craniofacial Research Center, Department of Medical Research, Department of Plastic Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
³ Graduate Institute of Chemical and Materials Engineering, College of Engineering, Chang Gung University, Taoyuan 333, Taiwan.
⁴ Craniofacial Center, Taipei Medical University Hospital and Department of surgery, Taipei 110, Taiwan.

Abstract

Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm³ vs. EGPP at 0.14 cm³, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.

Keywords: CT measurement of alveolar defect; alveolar cleft repair; bone volume; extensive gingivoperiosteoplasty; perioperative orthodontic treatment; secondary alveolar bone grafting.