Experiences with infant and delayed periosteoplasty.

At the Cleft Palate Centre, Uppsala, Sweden, the periosteoplasty procedure had been used since 1964 to obtain bone continuity in the maxillary alveolar cleft area. This operation is performed either in infancy or as an early secondary (delayed) procedure. The amount of new bone formed in the alveolar cleft area was classified in 4 types according to Hellquist & Skoog 1976. The influence of the periosteoplasty on craniofacial growth and dental occlusion was studied longitudinally in different series of patients from the Uppsala region of Sweden, operated on with either infant or delayed periosteoplasty. As a result of delayed periosteoplasty, good bone formation in the alveolar cleft area was noted in 80% of the cases in patients younger than 7 years of age at the time of operation, compared with 47% after infant periosteoplasty. In the patients subjected to delayed periosteoplasty, 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 subjected to delayed periosteoplasty was well within the limits reported for other Scandinavian cleft lip and palate materials of the same age and type of cleft, subjected neither to periosteoplasty nor to primary bone-grafting.