Our Summary

This research paper discusses a method called alveolar distraction osteogenesis (ADO), which has been used for many years to rebuild a part of the jawbone that has wasted away. The advantage of this method is that it builds up both the bone and the soft tissues at the same time, making a better foundation for future surgeries and dental work. It is particularly helpful in patients with large and/or complex gaps in this part of their jawbone, helping to reduce the size of the gap and any associated openings. The most common issue with this method is the shifting of the rebuilt area, but this can be managed by using specially designed devices for each individual case.

FAQs

  1. What is alveolar distraction osteogenesis (ADO) used for?
  2. How does ADO benefit patients with large and/or complex alveolar clefts?
  3. What is the most common complication of ADO and how is it managed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft palate surgery is to follow the post-operative care instructions provided by the surgeon closely to ensure proper healing and minimize complications. This may include instructions on wound care, pain management, dietary restrictions, and follow-up appointments. It is important to communicate any concerns or changes in symptoms to the medical team promptly.

Suitable For

Patients with large and/or complex alveolar clefts, who may benefit from alveolar distraction osteogenesis (ADO) include those with:

  1. Severe atrophic alveolus
  2. Large bony clefts
  3. Associated fistula
  4. Difficulty in approximating alveolar segments
  5. Need for augmentation of bone and soft tissues for subsequent surgeries and dental rehabilitation

These patients may be recommended for cleft palate surgery using ADO to improve the alveolar platform and facilitate better outcomes in their overall treatment plan.

Timeline

Before cleft palate surgery:

  1. Diagnosis: The patient is diagnosed with a cleft palate by a healthcare provider.
  2. Pre-surgical evaluations: The patient undergoes evaluations such as physical exams, imaging tests, and dental assessments to determine the extent of the cleft palate and plan for surgery.
  3. Pre-surgical counseling: The patient and their family receive counseling on the surgical procedure, potential risks and complications, and post-operative care.
  4. Pre-operative preparations: The patient may need to stop taking certain medications, fast before surgery, and follow specific instructions provided by the healthcare team.

After cleft palate surgery:

  1. Immediate post-operative care: The patient is monitored in the recovery room for a period of time to ensure their stability. Pain medication and antibiotics are often prescribed to manage pain and prevent infection.
  2. Hospital stay: The patient may need to stay in the hospital for a few days for observation and initial wound care.
  3. Follow-up appointments: The patient will have follow-up appointments with their healthcare provider to monitor healing progress, remove sutures, and address any concerns or complications.
  4. Speech therapy: Depending on the extent of the cleft palate and any associated speech difficulties, the patient may undergo speech therapy to improve communication skills.
  5. Long-term care: The patient may require additional surgeries or procedures in the future to address any residual issues related to the cleft palate, such as dental work or aesthetic improvements. Regular follow-up appointments will be scheduled to monitor the patient’s progress and overall health.

What to Ask Your Doctor

  • What are the potential risks and complications associated with cleft palate surgery?
  • How long is the recovery period and what can I expect during the healing process?
  • Will there be any visible scarring after the surgery?
  • What are the long-term effects of cleft palate surgery?
  • How soon after the surgery can I resume normal activities, such as eating and speaking?
  • Will additional surgeries or treatments be necessary in the future?
  • Can you provide me with information on the success rate of cleft palate surgeries?
  • Are there any specific dietary or lifestyle changes I should make before or after the surgery?
  • What type of anesthesia will be used during the surgery and what are the potential side effects?
  • Are there any alternative treatment options available for cleft palate that I should consider?

Reference

Authors: Esenlik E, DeMitchell-Rodriguez EM. Journal: Clin Plast Surg. 2021 Jul;48(3):419-429. doi: 10.1016/j.cps.2021.02.004. Epub 2021 May 8. PMID: 34051895