Clinical outcomes of gingivoperiosteoplasty performed in early childhood in patients with bilateral cleft lip and palate.

This study aims to investigate the postoperative maxillofacial growth and bone formation after gingivoperiosteoplasty (GPP) performed in early childhood for patients with bilateral cleft lip and palate (BCLP). Thirty non-syndromic patients with complete BCLP who underwent a two-stage palatoplasty protocol were enrolled. Their alveolar cleft sides were categorized into two groups based on whether GPP was applied at the timing of hard palate closure (GPP group, n = 33) or not (non-GPP group, n = 27). Computed tomography (CT) and lateral cephalograms both taken at 8 years of age were analysed. Bone bridge formation was significantly higher in the GPP group (93.9 %) compared to the non-GPP group (11.1 %). However, the mean proportion of the bone created within the alveolar cleft site measured at multiple vertical levels in the GPP group was 54.4 %. Lateral cephalometric analysis revealed that the GPP group showed both anteroposterior length of the maxilla (GPP: 46.5 ± 3.0 mm, non-GPP: 50.2 ± 2.3 mm) and ANB (GPP: 3.4 ± 3.0°, non-GPP: 6.6 ± 2.5°) significantly smaller than the non-GPP group. These results demonstrated that GPP, performed at 1.5 years of age for BCLP, resulted in insufficient new bone formation and negatively impacted maxillary development. Based on these findings, we have discontinued our GPP protocol for patients with BCLP.