Mountain West 2019 Abstract Supplement
INTRODUCTION: Classical repair of the cleft hard palate involves closure of nasal and oral mucosa without bony reconstitution. However, lack of bony support can lead to collapse of the maxillary arch, dental crowding and posterior cross-bite. To avoid the above, our institution performs two staged repair of the cleft palate with placement of demineralized bone matrix (DBX) into the residual palatal defect to re-create normal palatal anatomy.
METHODS: A retrospective review of children who underwent a two stage palatoplasty from 2016–18 was performed. At our institution, the soft palate is closed around 9 months of age and the hard palate repair around 2–3 years of age. During the second stage, the alveolar cleft was exposed to achieve a concomitant closure of the alveolus and hard palate. DBX was placed into the alveolar cleft and hard palate. These patients’ records, images, and dental impressions were reviewed for complications and changes in maxillary morphology.
RESULTS: 12 patients had a two stage palatoplasty with bone grafting in the second stage. None of the patients developed infection, hematoma, dehiscence, airway obstruction or fistulas. Dental impressions revealed less palatal arching and widening of the maxilla. All patients had normal occlusion.
CONCLUSIONS: Our early results support that there is less collapse of lateral segments and a more stable dental arch in patients who underwent bone grafting at the time of cleft palate repair. Wide exposure during the repair allows complete grafting of the maxillary bony deficit, which is not possible with traditional alveolar cleft repair.