Presurgical nasoalveolar molding and primary gingivoperiosteoplasty reduce the need for bone grafting in patients with bilateral clefts

Wojciech Dec, Pradip R. Shetye, Edward H. Davidson, Barry H. Grayson, Lawrence E. Brecht, Court B. Cutting, Stephen M. Warren

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Preoperative nasoalveolar molding (NAM) in combination with primary gingivoperiosteoplasty (GPP) reduces the need for secondary alveolar bone grafting by 60% in patients with unilateral cleft lip and palate (CL/P). Herein, we investigate the efficacy of NAM and primary GPP in patients with bilateral CL/P. All patients (n = 38) with bilateral CL/P who underwent NAM and primary GPP from 1988 to 1998 with at least 14 years of follow-up were included in this study. Panoramic and periapical radiographs were used to assess dentoalveolar bone formation. A total of 38 patients were identified with median follow-up of 18 years (range 14-26 years). Of the 27 patients who underwent bilateral GPP, 14 (51%) patients had successful dentoalveolar bone formation bilaterally and 13 (49%) had unilateral bone formation. No patient had a bilateral failure. Of the 11 patients who underwent unilateral GPP, 7 (63%) patients had successful dentoalveolar bone formation. Bilateral successful dentoalveolar bone formation following primary bilateral GPP has a dependent probability of 52% and a conditional probability of 82%.

Original languageEnglish (US)
Pages (from-to)186-190
Number of pages5
JournalJournal of Craniofacial Surgery
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Keywords

  • Cleft lip
  • bilateral
  • bone grafting
  • cleft alveolus
  • cleft palate
  • nasoalveolar molding
  • presurgical orthopedics
  • primary gingivoperiosteoplasty

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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