title: Acellular Dermal Graft in Secondary Cleft Lip Deficiencies: Assessment of Results With a Reproducible Quantitative Technique.
abstract: OBJECTIVE
  Considering the little evidence around acellular dermal graft application in secondary lip reshaping, this study is aimed to quantitatively examine the effect of acellular dermal graft in combination with Z-plasty technique in secondary defects of cleft lip.
  
  
  METHODS
  In this clinical investigation, patients with secondary unilateral cleft lip deformity were selected. Standard photographs were prepared for each patient. Subsequent to scar revision, submucosal tunneling and Z-plasty, implantable human acellular dermal graft was placed and fixed in submucosal pocket. Quantitative parameters included angle of symmetry , dimension of symmetry (DS), defect height (DH), parallel lines, and lip thickness were measured presurgically and 1 year after treatment. Pre and post-operative pictures were compared and the changes were documented according to the criteria. P value less than 0.05 were considered as significant.
  
  
  RESULTS
  Eighteen patients were included in this study. The difference of "DS" between normal side and cleft side was 3.1 ± 1.5 mm presurgically and 1.1 ± 1.8 mm postsurgically. The change was significant (P value < 0.05). The difference between pretreatment and posttreatment measures of "DS", "DH", and "Lip Thickness" were 2.75 ± 4.55, 3.43 ± 4.82, and 2.66 ± 3.04 mm, respectively. The results were significant (P value<0.05).
  
  
  CONCLUSIONS
  Based on the results, acellular dermal graft in combination with Z-plasty was able to improve lip deformity in patients with secondary defects of cleft lip. Further studies are recommended regarding the application of this technique in patients with bilateral cleft lip and severe "DH."
authors.affiliation: *Torabinejad Dental Research Center†Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Isfahan University of Medical Sciences, Isfahan‡Dental Materials Research Center and Department of Operative Dentistry, School of Dentistry, Qazvin University of Medical Science, Qazvin, Iran§Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
authors.forename: Bijan
authors.initials: B
authors.lastname: Movahedian Attar
authors.forename: Abbas
authors.initials: A
authors.lastname: Haghighat
authors.forename: Navid
authors.initials: N
authors.lastname: Naghdi
authors.forename: Saman
authors.initials: S
authors.lastname: Jokar
authors.forename: Reyhaneh
authors.initials: R
authors.lastname: Nazem
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghassemi
mesh_terms: D062088:Acellular Dermis; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation