title: Success rate of gingivoperiosteoplasty with and without secondary bone grafts compared with secondary alveolar bone grafts alone.
abstract: BACKGROUND
  Gingivoperiosteoplasty has been shown to eliminate the need for secondary alveolar bone grafting in 60 percent of patients. The purpose of this study was to compare radiographic alveolar anatomy following infant gingivoperiosteoplasty, secondary alveolar bone grafting, and secondary alveolar bone grafting in patients who had prior infant gingivoperiosteoplasty with inadequate bone formation.
  
  
  METHODS
  Seventy-four consecutive nonsyndromic patients (complete bilateral cleft lip-cleft palate, n = 12; complete unilateral cleft lip-cleft palate, n = 46; complete unilateral cleft lip and alveolus, n = 14) treated at New York University Medical Center were available for evaluation. Eighty-two complete alveolar cleft sites were assigned to three groups: gingivoperiosteoplasty (n = 30), secondary alveolar bone grafting (n = 41), and secondary alveolar bone grafting following gingivoperiosteoplasty (n = 11). All gingivoperiosteoplasties were performed at the time of primary lip surgery, and secondary alveolar bone grafting (cancellous iliac crest at 7 to 12.5 years of age) was performed before eruption of the permanent canine. Radiographs were measured according to the modified method of Long.
  
  
  RESULTS
  Seventy-three percent of gingivoperiosteoplasty cases did not require secondary alveolar bone grafting and none had fistulas. The rate of missing teeth in the total sample, adjacent to the cleft, was within normal limits for the population. Group 1 alone and groups 1 and 3 combined had superior alveolar anatomy compared with group 2 (p < 0.01). No significant differences existed between groups 1 and 3 (p > 0.05). Crest height was best in group 1 (p < 0.01), followed by group 3 and then group 2, with no difference between the latter two groups.
  
  
  CONCLUSIONS
  Gingivoperiosteoplasty alone or combined with secondary alveolar bone grafting results in superior bone levels when compared with conventional secondary alveolar bone grafting alone.
authors: Tokyo, Japan; and New York, N.Y. From the Division of Orthodontics, Showa University Dental Hospital, and the Institute of Reconstructive Plastic Surgery, New York University Medical Center.
authors: Yuki
authors: Y
authors: Sato
authors: Barry H
authors: BH
authors: Grayson
authors: Judah S
authors: JS
authors: Garfinkle
authors: Ingrid
authors: I
authors: Barillas
authors: Koutaro
authors: K
authors: Maki
authors: Court B
authors: CB
authors: Cutting
mesh_terms: D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005881:Gingiva / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D010521:Periosteum / Q000601:surgery; D012074:Remission Induction