Gingivoperiosteoplasty in 3-to-5-year-old patients with cleft lip and palate: a preliminary communication.

Closure of the alveolar cleft and the oronasal fistulas was achieved by gingivoperiosteoplasty in 26 patients with unilateral or bilateral cleft of the lip and palate. They were divided in two groups according to whether or not functional cheiloplasty was previously performed (group I comprised 12 patients, group II--14 patients). No systemic pre- or post-surgical orthodontic treatment was administered in both groups. The malocclusions before and after gingivoperiosteoplasty, the postoperative fistulas and the speech were evaluated. Prior to gingivoperiosteoplasty malocclusions were found in 16 children (4 in group I and 12 in group II). After gingivoperiosteoplasty better occlusion was achieved in 6 patients of group II and in 3 of group I. Malocclusions remained in 6 children of group II and in one of group I. Fistulas persisted in 3 children (group II--2, group 1--1). Rhinolalia was found in 7 children of group II and in none of group I. In conclusion, we think that gingivoperiosteoplasty can be performed successfully after eruption of the deciduous teeth, that is between 3 and 5 years of age. The quality of the cheiloplasty and palatoplasty performed prior to it is of great significance. Gingivoperiosteoplasty should be included as a separate surgical stage in the management of total cleft lip and palate.