Spontaneous bone regeneration after closure of the hard palate cleft: A literature review

Publication date: Available online 29 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Scheuermann Maria, Vanreusel Inne, Elke Van de Casteele, Nadjmi Nasser

Abstract

Background

There is a wide range of surgical techniques for the treatment of palatal clefts. Some of these surgical procedures result in postoperative osteogenesis at the palatal fissure. The aim of this review was to discuss the current approach of cleft palate surgery leading to spontaneous bone regeneration and to compare these different procedures. Moreover, the causes of bone regeneration, effects on maxillary growth and factors affecting bone regeneration on the hard palate are discussed.

Methods

The selected articles were found on Medline and Web of Science. The keywords for the search were "cleft palate", "bone regeneration", "palatoplasty", "reconstructive surgical procedures" and "cleft palate/surgery". Studies that examined the effect of primary palatoplasty on spontaneous bone regeneration in the hard palate in children were included in this review. Four articles were analyzed in the qualitative synthesis.

Results

Due to differences in patient characteristics and evaluation methods, it has been difficult to compare different surgical procedures. The use of a mucoperiosteal flap in combination with adequate closure of the mucosa is needed to obtain bone formation. The area with the largest amount of regenerated bone was located in the middle of the hard palate. In literature it was found that complete closure is considered unfavorable because of the negative effects on maxillary growth, but more studies are needed to confirm this. Of the factors that have been studied, only age turned out to be borderline significant.

Conclusion

Only a few studies with small sample size have been published on bone regeneration in the hard palate. More research is needed to validate these findings.

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