Outcome of gingivoperiosteoplasty for the treatment of alveolar clefts in patients with unilateral cleft lip and palate.

Gingivoperiosteoplasty (GPP) has produced inconsistent outcomes. The purpose of this prospective study was to investigate the effects of GPP on the production of bone and maxillary growth. We analysed postoperative cone-beam computed tomographic (CT) scans and intraoral dental photographs of 25 children with complete unilateral cleft lip and palate (UCLP) who were treated with GPP at the same time as their primary repair of the lip. Residual cleft defects and unsupported root ratios of central incisors adjacent to clefts were measured from scans. Dental arch relations were assessed from photographs using the Goslon (Great Ormond Street London and Oslo) yardstick. Eighteen children did not require secondary alveolar bone grafts. Residual cleft defects varied by site (20.4mm(3), 38.6mm(3), 88.2mm(3), and 135.2mm(3) for buccal coronal, palatal coronal, buccal apical, and palatal apical defects, respectively; p<0.001). Unsupported root ratios did not differ significantly between coronal and apical central incisors adjacent to clefts. The mean (SD) Goslon score was 4.52 (0.51). Most participants (n=18) who had a GPP did not need secondary alveolar bone grafting. GPP resulted in least bone on the palatal apical portion of the previous alveolar cleft and relatively good periodontal bony support of central incisors adjacent to the cleft. We no longer use GPP because of our concerns about maxillary growth.

The deceptive nature of root coverage results.

BACKGROUND: The purposes of this article are to: 1) propose a new method of reporting root coverage data; 2) compare existing root coverage techniques using the proposed data analysis method; and 3) discuss additional refinements to root coverage data analysis. Past studies have equated percent defect coverage with root coverage. This gives deceptive information about the magnitude of the residual recession defect. Defect coverage of 67% could actually amount to 92% root coverage. METHODS: The use of mean root lengths will permit the determination of true root coverage data. This should be reported in addition to defect coverage data. Also including frequency data will provide a better assessment of the predictability of the surgical techniques. RESULTS: A comparison table of root coverage studies demonstrates that the connective tissue graft is the most effective and predictable method that has been tested. CONCLUSIONS: Further refinements to data analysis may help researchers identify the determinants of predictable root coverage.

Soft and hard tissue resection in periodontal therapy.

The stabilization of inflammatory periodontal diseases (gingivitis and periodontitis) and result periodontal maintenance is achieved most effectively by first establishing health within the dento-gingival complex (connective tissue, junctional epithelium, and sulcus). Two forms of surgical periodontal therapy commonly employed to reach this endpoint are resective in nature:, the gingivectomy/gingivoplasty technique for soft tissue resection and the ostectomy (osteoectomy)/ osteoplasty approach for hard tissue resection. These two forms of therapy are presented here from a historical perspective through to today's accepted methodology. The are agumented by literature references and presentations of clinical cases.

[The characteristics of the choice by each of 6 periodontists of the site to be operated on on periodontal tissues]. / Osobennosti vybora operiruemogo uchastka na tkaniakh parodonta kazhdym iz shesti parodontologov.

Periodontal pockets deeper than 4-5 mm require surgical treatment. Records of surgical journals of a periodontology room over 6 years are reviewed and 2183 operations performed by six periodontologists are analyzed. The results of surgery are determined by patient's status, site of anesthesia, type of secondary adentia, convenience of surgical access, terms between operations. Individual features of surgical technique of each of the six surgeons are shown.