GINGIVO ALVEOLO PERIOSTEOPLASTY

Cleft lip and palate patients are frequently affected by cleft involving the alveolar bone of the maxilla. When the patients are affected by cleft alveolus, the eruption of the maxillary lateral incisor and canine is affected. The cleft of the alveolus also has an overall retarding affect on the growth of the maxilla. Secondary alveolar bone grafting is a surgery done to place a bone graft in the cleft alveolus area. The placement of the bone graft in this area facilitates eruption of the lateral incisors and canine teeth. It helps in the maintenance of arch integrity and prevents malocclusion in the cleft patients. But there are some disadvantages with this procedure like donor site morbidity, gait abnormalities. The bone graft for this surgery is usually harvested from the iliac crest area. This may lead to gait abnormalities and discomfort in some patients up to 3 days. Gingivoalveoloperiosteoplasty is a procedure in which the same procedure for the secondary alveolar bone grafting is followed but there is no use of bone grafting. This procedure was previously called as “boneless bone grafting”. In this procedure, the soft tissue barrier within the alveolar cleft is surgically removed and replaced with a gingivoperiosteal tunnel that facilitates bone healing through guided tissue regeneration. It is a form of inductive surgery that creates a favourable environment for augmented local healing and tissue generation. The benefit of this inductive surgery is the lack of donor morbidity. The Gingivoalveoloperiosteoplasty procedure minimizes the number of secondary surgeries by optimizing the results of primary surgery. PRF membrane can also be used between the alveolar cleft and the periosteal flap to enable better and faster healing. The early closure of the alveolar arch in some cases may cause iatrogenic restriction of facial growth and malocclusion. Thus the benefits must outweigh against the risks involved in this procedure. The video is shared below showing the procedure of Gingivoalveoloperiosteoplasty with PRF membrane.

All types of surgical repairs of cleft lip and palate, secondary revision surgeries, speech surgeries, speech therapy, secondary alveolar bone grafting and gingivoalveoloperiosteoplasty procedures and the required dental treatments are being done at Richardson’s dental &craniofacial hospital by Dr.Sunil Richardson & his team.