Clefts of the alveolus are typically treated around 6-10 years of age when bone can be taken from the hip, ribs etc of the patient and packed into the defect. However, a procedure which obviates the need for a bone grafting is the Gingivoalveoperiosteoplasty done at an early age. It utilizes the higher regenerative potential of children younger than 5 years old.
This procedure involves raising of a full mucoperiosteal flap from the neighbouring tissue and sliding it over the cleft to cover it. The periosteum of the adjacent area now covers the cleft area. Periosteum is a tissue rich in osteoblasts which are the bone forming cells. These deposit new bone into the defect and fill up the alveolus.
At Richardsons dental and craniofacial Hospital, we also fill the defect with platelet-rich plasma(PRP) derived from the patient’s blood. The PRP also releases growth factors which create a favourable environment for bone formation.
Here is a case of a four-year-old boy with cleft alveolus being treated by GAP at our centre. Regular follow-ups with the patients help the surgical team to identify the patients who can be helped by this GAP.