[Gingivoperiosteoplasty associated to bone graft: radiological evaluation].
BACKGROUND
Gingivoperiosteoplasty associated to bone graft is part of a therapeutic strategy applied to the first 20 years of a patient's life. Management is pluridisciplinary. Most authors recommend a bone graft in mixed dentition at the end of premaxillary growth. Retroalveolar and panoramic radiography are the most often used to assess the bone height of the grafted site. We retrospectively studied the radiographies of 57 alveolar grafts in 44 patients.


METHODS
Between 1999 and 2005, 44 patients underwent gingivoperiosteoplasty associated to bone graft. Thirteen underwent bilateral reconstruction. The surgical interventions were performed by the same surgeon. One year after surgery, the panoramic radiographies were analyzed by a single expert. The bone height compared to roots of adjacent teeth was classified in four grades. Grades 1 and 2 were considered as satisfactory or good and grades 3 and 4 not satisfactory and an indication for a new bone graft. In case of bilateral cleft, each side was analyzed independently.


RESULTS
Grades 1 and 2 accounted for 84.2% of grafts. There was no statistical difference in alveolar bone height between patients presenting with agenesis of the lateral incisive. Eighty-one percent of patients grafted with mixed dentition (66% of the cases) had satisfactory results (35% of grade 1 and 46% of grade 2). Patients operated on after 15 years (n=15) had good results in 75% of the cases, 33% were bilateral cleft patients. There was no statistical difference between patients operated on early and those with delayed surgery.


CONCLUSIONS
Radiological results for gingivoperiosteoplasty associated to bone graft are satisfactory. The procedure is easy, cheap, and reproducible. Evaluation with panoramic radiography is not as accurate as with the Denta Scan. CT scan is not used systematically to follow up alveolar cleft palate in children so as to limit irradiation. Volumetric tomography (cone beam) may be the best assessment.
Boland
F-X
FX
Service de chirurgie maxillofaciale et stomatologie, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Francois-Xavier.Boland@chu-rouen.fr
Drikes
S
S
Persac
S
S
Peron
J-M
JM
Delcampe
P
P
D000293:Adolescent; D000367:Age Factors; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000543:Alveoloplasty / Q000379:methods*; D000848:Anodontia / Q000209:etiology; D016025:Bone Transplantation / Q000000981:diagnostic imaging*; D002648:Child; D002971:Cleft Lip / Q000000981:diagnostic imaging / Q000601:surgery*; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000601:surgery*; D003481:Cuspid / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D009668:Nose Diseases / Q000209:etiology; D016155:Oral Fistula / Q000209:etiology; D010521:Periosteum / Q000000981:diagnostic imaging / Q000601:surgery*; D019252:Radiography, Dental, Digital; D011862:Radiography, Panoramic; D019651:Plastic Surgery Procedures / Q000379:methods; D016156:Respiratory Tract Fistula / Q000209:etiology; D012189:Retrospective Studies; D014092:Tooth Root / Q000000981:diagnostic imaging; D016896:Treatment Outcome