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Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty.

Publication ,  Journal Article
Santiago, PE; Grayson, BH; Cutting, CB; Gianoutsos, MP; Brecht, LE; Kwon, SM
Published in: Cleft Palate Craniofac J
January 1998

OBJECTIVE: The purpose of this study was to evaluate if narrowing and approximation of the alveolar cleft through presurgical alveolar molding followed by gingivoperiosteoplasty (GPP) at the time of lip repair reduces the need for a bone-grafting procedure. DESIGN: This was a retrospective blind study of patients with unilateral or bilateral alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon. Alveolar bone formation was assessed prior to the eruption of the maxillary lateral incisor or canine by clinical examination, panoramic and periapical radiographs, and/or a dental CT scan. The criterion for bone grafting was inadequate bone stock to permit the eruption and maintenance of the permanent dentition. SETTING: This study was performed at the Institute of Reconstructive Plastic Surgery by the members of the Cleft Palate Team. PATIENTS: All patients with unilateral (n = 16) or bilateral (n = 2) alveolar clefts who underwent presurgical infant alveolar molding and GPP by a single surgeon from 1985 to 1988 were studied. The control population consisted of all alveolar cleft patients (n = 14) who did not undergo alveolar modeling or GPP during the same time period. INTERVENTIONS: Presurgical alveolar modeling was performed with an intraoral acrylic molding plate. This plate was modified on a weekly basis to align the alveolar segments and close the alveolar gap. The surgical intervention consisted of a modified Millard GPP. MAIN OUTCOME MEASURES: The primary study outcome measure was the elimination of the need for a secondary bone graft in patients who underwent presurgical alveolar molding and GPP. RESULTS: Of the 20 sites in the 18 patients who underwent GPP, 12 sites did not require an alveolar bone graft. Of the 8 sites requiring a bone graft, 4 presented minimal bony defects. All 14 patients in the control group required bone grafts. CONCLUSIONS: In this series of 20 alveolar cleft sites treated with presurgical orthopedics and GPP, 60% did not need a secondary alveolar bone graft in the mixed dentition.

Duke Scholars

Published In

Cleft Palate Craniofac J

DOI

ISSN

1055-6656

Publication Date

January 1998

Volume

35

Issue

1

Start / End Page

77 / 80

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tooth Eruption
  • Tomography, X-Ray Computed
  • Single-Blind Method
  • Retrospective Studies
  • Reoperation
  • Radiography, Panoramic
  • Periosteum
  • Periapical Tissue
  • Palatal Obturators
 

Citation

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Santiago, P. E., Grayson, B. H., Cutting, C. B., Gianoutsos, M. P., Brecht, L. E., & Kwon, S. M. (1998). Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J, 35(1), 77–80. https://doi.org/10.1597/1545-1569_1998_035_0077_rnfabg_2.3.co_2
Santiago, P. E., B. H. Grayson, C. B. Cutting, M. P. Gianoutsos, L. E. Brecht, and S. M. Kwon. “Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty.Cleft Palate Craniofac J 35, no. 1 (January 1998): 77–80. https://doi.org/10.1597/1545-1569_1998_035_0077_rnfabg_2.3.co_2.
Santiago PE, Grayson BH, Cutting CB, Gianoutsos MP, Brecht LE, Kwon SM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998 Jan;35(1):77–80.
Santiago, P. E., et al. “Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty.Cleft Palate Craniofac J, vol. 35, no. 1, Jan. 1998, pp. 77–80. Pubmed, doi:10.1597/1545-1569_1998_035_0077_rnfabg_2.3.co_2.
Santiago PE, Grayson BH, Cutting CB, Gianoutsos MP, Brecht LE, Kwon SM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998 Jan;35(1):77–80.

Published In

Cleft Palate Craniofac J

DOI

ISSN

1055-6656

Publication Date

January 1998

Volume

35

Issue

1

Start / End Page

77 / 80

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tooth Eruption
  • Tomography, X-Ray Computed
  • Single-Blind Method
  • Retrospective Studies
  • Reoperation
  • Radiography, Panoramic
  • Periosteum
  • Periapical Tissue
  • Palatal Obturators