Tomographic assessment of bone formation after the collares technique of gingivoperiosteoplasty in patients with cleft lip and palate

摘要

Objectives: This cross-sectional study sought to assess bone formation and spontaneous tooth eruption in a cohort of 25 consecutive patients aged 6 to 11 years who underwent primary gingivoperiosteoplasty by the Collares technique. Design: Cross-sectional study assessing bone formation in the cleft area using a withingroup time series design. Setting: Hospital de Clínicas de Porto Alegre (HCPA), a tertiary hospital in Brazil. Patients: Twenty-five patients with nonsyndromic, complete unilateral cleft lip and palate, no comorbidities, and unerupted permanent canines. Intervention: Cheiloplasty was performed by means of the Millard II technique, with the addition of a triangle at the mucocutaneous junction, vomer flap nasal floor closure, and wide subperiosteal elevation, followed by gingivoperiosteoplasty by the Collares technique. Main Outcome Measures: Cone-beam computed tomography was used to assess treatment effect. In a novel method, software was used to obtain two three-dimensional reconstructions, one each of the cleft and noncleft sides, enabling quantitative comparison of bone presence in the alveolar defect area. Results: Of the 25 patients, 24 achieved bone bridge formation. The cleft side had 75.1% (67.9%-82.3%) of the bone volume, 70.5% (53.1%-87.9%) of the height, and 63.3% (44.1%-82.5%) of the width of the noncleft side. Bone formation was 17.28% lower in patients with lateral incisor agenesis. Conclusion: Collares gingivoperiosteoplasty performed well as a technique for alveolar repair in patients with cleft lip and palate, allowing spontaneous eruption of deciduous and permanent lateral incisors through the bone bridge created.