Maxillary Growth following Atelocollagen Implantation on Mucoperiosteal Denudation of the Palatal Process in Young Rabbits: Implications for Clinical Cleft Palate Repair

1997 ◽  
Vol 34 (4) ◽  
pp. 297-308 ◽  
Author(s):  
Masaki Fujioka ◽  
Tohru Fujii

Objective: The implantation of atelocollagen matrix on the denuded surface of palatal bone following cleft palate repair has been used because it enhances wound healing. This study was performed to determine whether the beneficial effect of atelocollagen matrix implantation on the prevention of scar tissue contraction also inhibits the scar's interference with the growth of maxillary bone. Method: Fifty New Zealand White rabbits (aged 4 weeks) underwent palatal mucoperiosteal denudation, and atelocollagen matrix was implanted on the left palatal process. The opposite side was left open as a control. Results: Histopathologically, the implantation side exhibited early infiltration of mononuclear cells and fibroblasts, and better growth of connective tissue strands and epithelium. in addition, the formation of rete ridges were seen that were similar to the normal mucosa. The bone of the atelocollagen-implanted side was covered with regenerated periosteum-like layers, but that of the control side was lined by granulation tissue, suggesting the existence of continuous inflammation on the periosteal region. When the animals reached adulthood (aged 24 weeks), the areas of scars and palatal processes, palatal shelf width, molar teeth incline, and bone mineral contents were measured and compared between sides. The atelocollagen-applied scars showed less contraction, the area and width of atelocollagen-implanted palatal processes showed more satisfactory growth, and the dental arch deformity was suppressed in comparison with the control side. Conclusions: Our results suggest that the use of atelocollagen matrix on the denuded bone surface following cleft palate repair decreases the scar's effect on maxillary growth.

2017 ◽  
Vol 5 (1) ◽  
pp. e1201 ◽  
Author(s):  
Percy Rossell-Perry ◽  
Omar Cotrina-Rabanal ◽  
Olga Figallo-Hudtwalcker ◽  
Alicia Gonzalez-Vereau

1995 ◽  
Vol 41 (3) ◽  
pp. 220-223 ◽  
Author(s):  
Kazuhiro ONO ◽  
Yasushi OHASHI ◽  
Yoji KANNARI ◽  
Shinsaku ISONO

2017 ◽  
Vol 28 (4) ◽  
pp. 909-914
Author(s):  
Rachel Skladman ◽  
Lynn Marty Grames ◽  
Gary Skolnick ◽  
Dennis C. Nguyen ◽  
Sybill D. Naidoo ◽  
...  

2021 ◽  
pp. 105566562110174
Author(s):  
Thomas R. Cawthorn ◽  
Anna R. Todd ◽  
Nina Hardcastle ◽  
Adam O. Spencer ◽  
A. Robertson Harrop ◽  
...  

Objective: To evaluate the development process and clinical impact of implementing a standardized perioperative clinical care pathway for cleft palate repair. Design: Medical records of patients undergoing primary cleft palate repair prior to pathway implementation were retrospectively reviewed as a historical control group (N = 40). The historical cohort was compared to a prospectively collected group of patients who were treated according to the pathway (N = 40). Patients: Healthy, nonsyndromic infants undergoing primary cleft palate repair at a tertiary care pediatric hospital. Interventions: A novel, standardized pathway was created through an iterative process, combining literature review with expert opinion and discussions with institutional stakeholders. The pathway integrated multimodal analgesia throughout the perioperative course and included intraoperative bilateral maxillary nerve blocks. Perioperative protocols for preoperative fasting, case timing, antiemetics, intravenous fluid management, and postoperative diet advancement were standardized. Main Outcome Measures: Primary outcomes include: (1) length of hospital stay, (2) cumulative opioid consumption, (3) oral intake postoperatively. Results: Patients treated according to the pathway had shorter mean length of stay (31 vs 57 hours, P < .001), decreased cumulative morphine consumption (77 vs 727 μg/kg, P < .001), shorter time to initiate oral intake (9.3 vs 22 hours, P = .01), and greater volume of oral intake in first 24 hours postoperatively (379 vs 171 mL, P < .001). There were no differences in total anesthesia time, total surgical time, or complication rates between the control and treatment groups. Conclusions: Implementation of a standardized perioperative clinical care pathway for primary cleft palate repair is safe, feasible, and associated with reduced length of stay, reduced opioid consumption, and improved oral intake postoperatively.


2017 ◽  
Vol 28 (5) ◽  
pp. 1164-1166 ◽  
Author(s):  
Robin Wu ◽  
Alexander Wilson ◽  
Roberto Travieso ◽  
Derek M. Steinbacher

Sign in / Sign up

Export Citation Format

Share Document