Effects of primary periosteoplasty on facial growth in unilateral cleft lip and palate: 10-year follow-up.

Cephalometric radiographic assessment of facial growth was carried out in 35 10-year-old boys with complete unilateral cleft lip and palate, operated upon in childhood with the technique of primary periosteoplasty. They were compared with two matched series of boys with clefts; one group was treated with primary osteoplasty and the second with the technique of surgical repair without a bone graft or periosteal flap. Comparison of the three surgical techniques disclosed that subsequent jaw development was most advantageous after primary periosteoplasty and least satisfactory after bone grafting. Facial changes after periosteoplasty consisted of a milder retrusion of the upper jaw, a maintenance of the overjet, and a more satisfactory prominence of the upper lip. Analysis also revealed that orthodontic treatment appeared to play a major part in improving the facial configuration.