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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 1998 October-December;157(5-6):141-8
Evaluating the quantity of bone produced in the site of schisis using 3D cat in patients with cheilognathopalatoschisis undergoing maxillary reconstruction using Massei’s three layer periostioplasty
Gatti G. L. 1, Abruzzese A. 2, Massei A. 1
1 Azienda Ospedaliera Pisana - Pisa, UO di Chirurgia Plastica e Sezione di Microchirurgia;
2 Azienda Ospedaliera Pisana - Pisa, UO di Neuroradiologia
Background and aims. The authors compare two sample groups of patients with cheilognatho-palatoschisis undergoing corrective surgery using the same protocol in order to evaluate the quantity of newly formed bone in the site of maxillary schisis after early periostioplasty using Massei’s technique. 3D CAT was used to evaluate the quantity of newly formed bone both vertically (from the piriform aperture to the dentoalveolar portion of the jaw), and in an antero-posterior sense (from the vestibular cortex to the palatal cortex). The authors propose a new classification of bone production.
Methods. Two sample groups of patients were studied using 3D CAT with axial scans of the site of schisis: the first group comprised 19 schisis treated between 1977 and 1980, and the second included 8 schisis treated between 1984 and 1988. All patients were operated by the same surgeon with early periostioplasty performed under the age of two months. Oxidised and regenerated cellulose (Tabotamp) was always used in the first group, inserted in the periosteal flap, and one or two surgical controls of the jawbone were performed; Tabotamp was never used in the second group and no long-term surgical controls were performed.
Results. In the first group bone production was good and bone grafts were not required in 89.4% of cases; in 10.6%, bone production was adequate but a targeted graft of a moderate size was required. No cases were observed where no bone was produced after early periostioplasty. In the second group, bone production was lower: bone graft was not required in 12.5% of cases, whereas a minimum bone graft was necessary in 62.5% of cases, and in 25% there was no bone production.
Conclusions. The quantity of newly formed bone after early periostioplasty was optimal in the first sample group, confirming the value of this technique. Further studies will be carried out to establish whether the statistically significant differences between the two sample groups should be ascribed to the use of Tabotamp and/or long-term surgical controls carried out on patients in the first group.