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Gingivoperiosteoplasty and midfacial growth

R J Wood1, B H Grayson, C B Cutting

  • 1Center for Cleft and Craniofacial Anomalies, Emory University School of Medicine, Atlanta, GA 30322, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|January 1, 1997
PubMed
Summary

Gingivoperiosteoplasty (GPP) in unilateral cleft lip and palate patients did not impair midfacial growth at 6 years. GPP resulted in a more uniform hard palate position compared to controls.

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Area of Science:

  • Craniofacial Surgery
  • Pediatric Plastic Surgery
  • Orthodontics

Background:

  • Primary surgical repair of complete unilateral cleft lip and palate aims to optimize facial growth.
  • Gingivoperiosteoplasty (GPP) is a surgical technique used during primary repair, but its long-term effects on midfacial growth are debated.
  • Understanding the impact of GPP on skeletal development is crucial for surgical planning and patient outcomes.

Purpose of the Study:

  • To evaluate the effect of gingivoperiosteoplasty (GPP) on midfacial skeletal growth 6 years after primary surgical repair in patients with complete unilateral cleft lip and palate.
  • To compare cephalometric measurements of the maxilla between patients who underwent GPP and those who did not.

Main Methods:

  • Retrospective comparison of lateral cephalograms from 20 patients with complete unilateral cleft lip and palate, 6 years post-primary repair.

Related Experiment Videos

  • Patients were divided into two groups: those who received GPP and those who did not.
  • Analysis included cranial base (S-N), maxilla (ANS-PNS), and mandible (Go-Pg) using shape coordinate analysis.

    • Main Results:

    • No significant difference in the mean anteroposterior or superoinferior position of the maxilla (ANS-PNS) was observed between groups.
    • A significant difference in the variance of the maxillary position (ANS-PNS) was found, with GPP leading to more uniform positioning (p < .002).
    • No clear impairment of maxillary growth was demonstrated in patients treated with GPP compared to controls.

    Conclusions:

    • Gingivoperiosteoplasty (GPP) does not appear to negatively impact overall maxillary growth at 6 years post-primary repair.
    • GPP contributes to a more consistent and uniform position of the hard palate (ANS-PNS) in patients with unilateral cleft lip and palate.
    • These findings suggest GPP can be safely employed without compromising midfacial skeletal development.