title: Effects of palatine bone denudation repair with periosteal graft on maxillary growth: an experimental study in rats.
abstract: BACKGROUND
  The long-term goal of cleft palate repair is to provide normal maxillary growth and speech capacity. However, most surgical repairs of cleft palate result in areas of bone denudation on lateral aspects of the hard palate. It is widely acknowledged that palatal bone denudation and subsequent scar contracture resulting from cleft palate surgery can inhibit maxillary growth.
  
  
  METHODS
  This study is designed to investigate the effect of the periosteum on growth patterns of the maxilla. A total of 32 three-week-old Sprague-Dawley rats were randomly divided into a control group and three experimental groups: a mucosa excision group, a mucosa-periosteum excision group and a periosteal graft group. Nine weeks postoperatively the skulls were prepared for study and palatal widths and lengths were determined. The experimental groups were investigated for various histological changes.
  
  
  RESULTS
  There was no statistically significant difference for the maxillary measurements (palatal width and length) between the mucosa excision group and the periosteal graft group when compared with the control group. However, the mucosa-periosteum excision group compared to the control indicated a statistically significant decrease in the same measurements. There was also a statistically significant difference for the maxillary measurements between the periosteal graft group and the mucosa-periosteum excision group. It was demonstrated histologically that the density of the Sharpey's fibres and periodontal scar tissue showed a slight increase in the mucosa excision group and the periosteal graft group compared with the control group. In the mucosa-periosteum excision group, the density increased significantly as expected.
  
  
  CONCLUSIONS
  All of these findings testify that retaining the periosteum or replacement with a periosteum graft after surgery can prevent the inhibition of maxillary growth.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Bursa Government Hospital, Bademli, Bursa, Turkey. Electronic address: drsedaasfur@gmail.com.
authors.forename: Seda Asfuroğlu
authors.initials: SA
authors.lastname: Barutca
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Aksan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Usçetin
authors.affiliation: Department of Pathology, Marmara University, Istanbul, Turkey.
authors.forename: Davut
authors.initials: D
authors.lastname: Sahin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mithat
authors.initials: M
authors.lastname: Akan
mesh_terms: D000818:Animals; D002508:Cephalometry / Q000379:methods; D002921:Cicatrix / Q000473:pathology; D003094:Collagen / Q000648:ultrastructure; D003238:Connective Tissue / Q000473:pathology; D003724:Dental Arch / Q000254:growth & development / Q000473:pathology; D004195:Disease Models, Animal; D005347:Fibroblasts / Q000473:pathology; D008297:Male; D008437:Maxilla / Q000254:growth & development* / Q000473:pathology; D009061:Mouth Mucosa / Q000601:surgery; D021362:Palate, Hard / Q000473:pathology / Q000601:surgery*; D010521:Periosteum / Q000601:surgery / Q000637:transplantation*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D003094:Collagen
keywords: Cleft palate; Denuded bone; Maxillary growth; Periosteal graft