Initial treatment of alveolar gaps in cases of labio-maxillary-palatal clefts

Address for correspondence: A. Picard, Service de Chirurgie maxilla-faciale et plastique, 26, avenue du Dr A. Netter, 75571 Paris Cedex 12. a.picard@trs.aphp.fr.

Abstract

Treatment teams use different approaches for correcting the alveolar cleft sector of labio-palatal clefts. Age of patient, whether or not bone grafts are used, and the type of bone grafted are some of the differences. Our team performs a gingivoperioplasty with a graft of iliac cancellous bone on patients 4 to 6 years old. This procedure is carried out within the framework of orthodontic treatment designed to restore transverse dimension pre-operatively with a quad helix and to retain the expansion with 6 months of retention. The gingivoperioplasty is accomplished in a zone free of any scar tissue that might have resulted from a primary cheiloplasty followed by closure of the palatal cleft. In our view all teams must eventually utilize cone beam X-rays for their radiographic evaluations because they are the only tool that provides results of objective analysis that are of high quality and have demanded a very low level of radiation.