Gingivoperiosteoplasty following Alveolar Molding with a Latham Appliance versus Secondary Bone Grafting: The Effects on Bone Production and Midfacial Growth in Patients with Bilateral Clefts
Bibliographic record
Abstract
BACKGROUND: The role of gingivoperiosteoplasty in closure of bilateral alveolar clefts remains unclear. The purpose of this study was to evaluate bone production and midfacial growth in patients with bilateral clefts treated with gingivoperiosteoplasty following alveolar molding with a pin-retained Latham appliance versus secondary bone grafting. METHODS: Patients with complete bilateral clefts past permanent canine eruption were included. Ethics approval and informed consent were obtained. Periapical films and lateral cephalograms were analyzed by one blinded rater based on three radiographic grading scales--Bergland, Witherow et al., and Long et al.--and standard cephalometric landmarks, respectively. Repeated measurements were recorded to assess intrarater reliability. Measurements were grouped according to gingivoperiosteoplasty versus secondary bone grafting and compared using parametric and nonparametric tests. RESULTS: Fifty-three patients (gingivoperiosteoplasty, n = 43; secondary bone grafting, 10) met inclusion criteria. Average age was 15 years and 66 percent were male patients. Thirty-five patients had adequate radiographs for evaluation (gingivoperiosteoplasty, n = 25; secondary bone grafting, n = 10). Gingivoperiosteoplasty was clinically less successful than secondary bone grafting, 58 percent versus 90 percent, respectively. The quantitative radiographic success rate of gingivoperiosteoplasty, however, was 28 percent. Secondary bone grafting demonstrated higher Bergland, eight-point, and location grading (p < 0.002), and less alveolar notching (p = 0.008). Anteroposterior maxillary and mandibular dimensions were significantly decreased for the gingivoperiosteoplasty group versus the secondary bone grafting group. CONCLUSIONS: Bone quantity and location were inferior following bilateral gingivoperiosteoplasty versus secondary bone grafting, and the majority of patients required subsequent bone grafting. The gingivoperiosteoplasty group had decreased maxillary growth with mandibular compensation. Secondary bone grafting therefore remains our first choice for repair of bilateral alveolar clefts.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".