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Outcomes of alveolar cleft repair in complete cleft lip and palate after tertiary gingivoperiosteoplasty and segmental Le Fort I osteotomy

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Abstract

Objectives

Gingivoperiosteoplasty is often used for reconstruction of alveolar defects in infants with cleft lip and palate. This study aimed to examine outcomes of tertiary gingivoperiosteoplasty, which has not previously been investigated.

Materials and methods

This prospective study included 11 adults with complete cleft lip and palate (n = 12 sites) who consecutively underwent segmental Le Fort I osteotomy and concomitant gingivoperiosteoplasty for correction of skeletal class III deformity, nasoalveolar fistula and alveolar cleft. Outcomes included clinical and radiographic evaluations of gingivoperiosteoplasty at the time of osteotomy (presence of nasoalveolar fistula, residual cleft defect and unsupported root ratio of cleft-adjacent teeth), and determination of influencing factors for the clinical success of alveolar cleft repair. Study variables included age, gender, pre-surgical orthodontic treatment and alveolar cleft width of cleft-adjacent canine and angulation between cleft-adjacent teeth before surgery and 1-week postsurgery.

Results

Posttreatment, no nasoalveolar fistula remained. The residual cleft defect decreased significantly (p < 0.01). The unsupported root ratio of cleft-adjacent teeth did not differ (p > 0.05); eight cleft sites reached Bergland I or II (67% success). One-week postsurgery, the minimal alveolar cleft width of cleft-adjacent canine was significantly less in the success group compared with the failed group (p = 0.01).

Conclusions

Tertiary gingivoperiosteoplasty and segmental Le Fort I osteotomy decreased nasoalveolar fistulas and induced alveolar bone formation. The minimal alveolar cleft width immediately after surgery was the major influencing factor of clinical success.

Clinical relevance

Segmental Le Fort I osteotomy with simultaneous gingivoperiosteoplasty efficaciously repairs adult alveolar clefts.

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Data availability

Data are available from the corresponding author on reasonable request.

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Funding

The work was supported by the Chang Gung Memorial Hospital, Taiwan (CMRPG5M0091-93).

Author information

Authors and Affiliations

  1. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan

    Yi-Chin Wang

  2. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Ting-Chen Lu & Ying-An Chen

  3. Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan

    Ting-Chen Lu, Ying-An Chen & Yu-Fang Liao

  4. Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Ting-Chen Lu, Ying-An Chen & Yu-Fang Liao

  5. Craniofacial Center, Taipei Medical University Hospital, Taipei, Taiwan

    Philip Kuo-Ting Chen

  6. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuan City, 333, Taiwan

    Yu-Fang Liao

  7. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Yu-Fang Liao

Authors
  1. Yi-Chin Wang
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  2. Ting-Chen Lu
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  4. Philip Kuo-Ting Chen
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Contributions

Y.C.W., P.K.T.C. and Y.F.L. wrote the main manuscript text; all authors conducted the investigations and reviewed the manuscript.

Corresponding author

Correspondence to Yu-Fang Liao.

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Ethical approval

The study was approved by the local ethic committee of the Chang Gung Memorial Hospital. All study participants signed informed consent.

Competing interests

The authors have nothing to disclose.

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Wang, YC., Lu, TC., Chen, YA. et al. Outcomes of alveolar cleft repair in complete cleft lip and palate after tertiary gingivoperiosteoplasty and segmental Le Fort I osteotomy. Clin Oral Invest 27, 4643–4652 (2023). https://doi.org/10.1007/s00784-023-05090-3

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  • DOI: https://doi.org/10.1007/s00784-023-05090-3

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