A Personal Experience of Buccal Flaps for Cleft Palate Repair and the Effect of Buccal Flaps on Dentition

To assess the effect of buccal mucosal flaps for cleft palate (CP) repair on dental hygiene and eruption of the posterior molar teeth.

A retrospective review of CP patients between 2008 and 2015 from our prospective (live) CP database.

A single-center University Hospital with a senior cleft surgeon and a senior pediatric dentist undertaking the dental review.

All CP patients who underwent a buccal mucosal flap (n=38).Exclusion criteria included incomplete dental data sets or previous buccal flap pedicle division, leaving n=31 patients. Key parameters of dental hygiene and development were recorded.

To assess posterior molar eruption and hygiene.

Thirty-one patients were included: (n=2) had a fistula, and (n=29) had a buccal band, with (n=5) receiving division of the buccal band (as an adjunct to another procedure). The "presence of plaque on the buccal surface of the most distal molar tooth score"=0 bilaterally (n=7), 1 bilaterally (n=19), 2 (n=3), and 3 unilaterally (n=2). The gingival probing depth was between 1 and 2 mm bilaterally (n=30) and 3 mm on the side of the buccal flap (n=1). The crown height measurements varied from 2 to 8 mm and were symmetrical (n=24) or within 1 mm of each other (n=4) or 2 mm of each other (n=3). Depth of the buccal sulcus to the most distal upper molar tooth measurements varied from a difference between sides of: 0 mm (n=8), 1 mm (n=6), 2 mm (n=13), and 3 mm (n=4).

The single-stage buccal mucosal flap is a useful technique in CP repair and appears to have minimal negative effects on dental hygiene and no observed significant impact on dental eruption.