Metric results of vestibuloplasty in unilateral cleft patients

Comparative Evaluation of Two Different Vestibuloplasty Surgical Procedures in Cleft Patients: A Pilot Study

Objective

Patients with a cleft lip or palate often present alterations in the labial aspect of the ridge, resulting in a shallow vestibule. This study compares the results of two different surgical procedures on deepening of the labial sulcus.

Interventions

Ten patients with a cleft lip and palate were separated into two groups and underwent different vestibuloplasty procedures. An experimental group used a removable retention splint. Preoperative and 4-month postoperative sulcus heights were measured and analyzed statistically.

Results

No statistically significant differences could be detected between groups.

Conclusion

The results indicated that to reach consistent results, a larger number of patients must be submitted to this evaluation.

Effect of Carbon Dioxide Laser on Increasing Vestibular Depth in Cleft Lip and Palate Patients

BACKGROUND

Shallow upper buccal sulcus deformity in cleft lip and palate patients is one of the common secondary deformities after primary cleft lip and palate repair; this deformity may prevent or complicate orthodontic and prosthodontic procedures causing aesthetic and functional problems. A number of methods are described to increase the anterior maxillary sulcus in these patients.

PURPOSE

This study assessed the use of a carbon dioxide laser (CO₂) to increase the sulcus depth.

METHOD

Fifteen patients with cleft lip and palate (eight unilateral and seven bilateral) were studied. The surgical procedure was performed using CO₂ laser. The vestibular depth and lip length were measured at three time points namely before surgery (T0), 1 week following surgery (T1), and 4 months following surgery (T2). After data collection, statistical analyses were done using PASW^® version 18 SPSS.

RESULTS

The mean values of vestibular depth were 9.46 ± 1.92, 13.83 ± 1.88, and 13.23 ± 1.76 mm for T0, T1, and T2, respectively. The vestibular depth significantly increased after 4 months of follow-up (p = 0.001). The mean amount of vestibular depth gain was not significantly different in unilateral and bilateral cleft groups (p = 0.908). The mean value of upper lip length increased by a mean of 1.23 mm and was statistically significant (p = 0.001).

CONCLUSIONS

Upper buccal sulcus reconstruction with CO₂ laser provides successful and stable results. CO₂ laser application is suggested as an alternative to conventional vestibuloplasty.

Gingival recession in maxillary canines and central incisors of individuals with clefts

BACKGROUND

Mucogingival alterations are inherent to clefts and may be worsened by the several plastic surgeries required in these individuals.

OBJECTIVE

The aim of this study was to evaluate the prevalence, severity, and some possible etiologic factors of gingival recessions in teeth adjacent to the cleft.

STUDY DESIGN

A total of 641 teeth (maxillary canines and central incisors) of 193 individuals with cleft lip and/or palate were examined. A generalized linear model was used, and the Wilcoxon test was used to compare the recession with cleft types.

RESULTS

Comparison among cleft types as to the presence of recession revealed a statistically significant positive relationship for the maxillary right and left central incisors only in the group with left cleft lip, alveolus, and palate (P = .034). The most frequently affected tooth was the right maxillary canine (26.16%).

CONCLUSION

The prevalence of recession in teeth close to the cleft was higher, although it was not very severe.