title: Skoog Primary Periosteoplasty versus Secondary Alveolar Bone Grafting in Unilateral Cleft Lip and Alveolus: Long-Term Effects on Alveolar Bone Formation and Maxillary Growth.
abstract: BACKGROUND
  Clefts involving the alveolus are treated using one of two strategies: primary periosteoplasty at the time of lip repair or secondary alveolar bone grafting at mixed dentition. Most teams favor secondary alveolar bone grafting because of its high success rate, and concerns have been raised that primary periosteoplasty may interfere with maxillary growth. However, primary periosteoplasty may obviate the need for future bone grafting and is still practiced in some centers. Few studies compare the long-term outcomes of these two strategies.
  
  
  METHODS
  Fifty-seven consecutive patients born with unilateral cleft lip and alveolus were studied retrospectively. All patients underwent primary lip repair using Skoog's method; 28 patients underwent primary periosteoplasty at the time of lip repair and the remaining 29 underwent secondary alveolar bone grafting at mixed dentition. Occlusal radiographs obtained at ages 10 and 16 years were analyzed for alveolar bone height. Cephalometric analysis assessed growth at ages 5, 10, and 18 years.
  
  
  RESULTS
  Seventeen of 28 patients treated using primary periosteoplasty required later secondary bone grafting, and the bone height at age 16 years was lower in the primary periosteoplasty group (p < 0.0001). There was a more pronounced decrease in maxillary protrusion from ages 5 to 10 years in the primary periosteoplasty group (p < 0.03). However, at age 18 there was no significant difference in maxillary growth between the two groups.
  
  
  CONCLUSIONS
  Primary periosteoplasty did not seem to inhibit long-term maxillary growth but was ineffective as a method of reconstructing the alveolar cleft.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Fatima
authors.initials: F
authors.lastname: Jabbari
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Malin M
authors.initials: MM
authors.lastname: Hakelius
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Andreas L I
authors.initials: ALI
authors.lastname: Thor
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Reiser
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Valdemar T
authors.initials: VT
authors.lastname: Skoog
authors.affiliation: Uppsala, Sweden.|From the Department of Surgical Sciences, Maxillofacial Surgery, and the Department of Surgical Sciences, Plastic Surgery, Uppsala University Hospital.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Nowinski
mesh_terms: D000293:Adolescent; D064728:Alveolar Bone Grafting; D000539:Alveolar Process / Q000254:growth & development / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008437:Maxilla / Q000254:growth & development; D010521:Periosteum / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome