A longitudinal study of delayed periosteoplasty to the cleft alveolus.

The effects of delayed periosteoplasty were studied longitudinally from 5 to 17 years of age in 35 consecutive cases (24 boys and 11 girls) with clefts involving the maxillary alveolar process. The mean age at operation was 6.4 years. In patients younger than 7 years of age at the time of delayed periosteoplasty, good bone formation developed in 80%, compared with 47% after infant periosteoplasty. After delayed periosteoplasty the formation of new bone continued an average of 5 years postoperatively. The frequency of anterior crossbite was lower than that reported for other Scandinavian cleft lip and palate materials of the same age and type of cleft. Cephalometric analysis indicated that growth of the facial skeleton of the patients in the present material was well within the limits reported for the above-mentioned Scandinavian materials subjected neither to periosteoplasty nor to bone-grafting. The results indicate that delayed periosteoplasty might be a superior method in the reconstruction of the alveolar cleft in young individuals.