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Evaluation of Bone Regeneration in Single Stage Closure of Cleft Alveolus with Gingivoperiosteoplasty

Background: Cleft alveolus closure is a challenge for cleft surgeon for many decades. Secondary 
alveolar bone grafting (SABG) is the preferred technique using autologous 
cancellous ileac crest bone as the donor 
graft. Many alternative methods were tried over the years with no any promising results. Gingivoperiosteoplasty (GPP) is a good alternative 
surgical technique for bone regeneration in cleft alveolus with proper case 
selection criteria. Aim: Aim of the study was to evaluate the bone 
regeneration following closure of cleft 
alveolus with gingivoperiosteoplasty. Method: This study was carried out in the department of Oral and Maxillofacial 
Surgery, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India, 
from March 2018 to July 2019. In this study, we 
have performed gingivoperiosteoplasty with palatoplasty and evaluated the amount of bone formation in the cleft 
alveolus using a series of intra oral periapical radiographs. Five patients who required surgical repair of 
unilateral cleft palate and alveolus were selected for the study. Clinical and radiographical assessment was done post operatively, after three and six 
months respectively for anatomical function and bone formation. Results: After completion of clinical studies on patients, the statistical analysis of the data obtained. 
Radiographs were analyzed for grey scale density by means of adobe photo shop using the MATLAB process by histogram comparison in three months and six months, showing 
denser grey scale pattern, indicating the 
new bone formation in the cleft alveolus surgical site, in all the 5 surgical 
cases. Conclusion: Gingivoperiosteoplasty (GPP) is a good 
alternative procedure to secondary 
alveolar bone grafting (SABG), so donor site morbidity can be avoided with 
reduced time and cost for the surgery. But a larger sample size and longer 
follow-up are necessary to understand the better reliability of this surgical 
technique. Clinical Significance: Gingivoperiosteoplasty in cleft 
alveolus patients showed significant bone formation in 3 to 6 months 
postoperatively.