A Personal Experience of Buccal Flaps for Cleft Palate Repair and the Effect of Buccal Flaps on Dentition

OBJECTIVE: To assess the effect of buccal mucosal flaps for cleft palate (CP) repair on dental hygiene and eruption of the posterior molar teeth. DESIGN: A retrospective review of CP patients between 2008 and 2015 from our prospective (live) CP database. SETTING: A single-center University Hospital with a senior cleft surgeon and a senior pediatric dentist undertaking the dental review. PATIENTS, PARTICIPANTS: All CP patients who underwent a buccal mucosal flap (n=38).Exclusion criteria included incomplete dental data sets or previous buccal flap pedicle division, leaving n=31 patients. Key parameters of dental hygiene and development were recorded. MAIN OUTCOME MEASURES: To assess posterior molar eruption and hygiene. RESULTS: Thirty-one patients were included: (n=2) had a fistula, and (n=29) had a buccal band, with (n=5) receiving division of the buccal band (as an adjunct to another procedure). The "presence of plaque on the buccal surface of the most distal molar tooth score"=0 bilaterally (n=7), 1 bilaterally (n=19), 2 (n=3), and 3 unilaterally (n=2). The gingival probing depth was between 1 and 2 mm bilaterally (n=30) and 3 mm on the side of the buccal flap (n=1). The crown height measurements varied from 2 to 8 mm and were symmetrical (n=24) or within 1 mm of each other (n=4) or 2 mm of each other (n=3). Depth of the buccal sulcus to the most distal upper molar tooth measurements varied from a difference between sides of: 0 mm (n=8), 1 mm (n=6), 2 mm (n=13), and 3 mm (n=4). CONCLUSIONS: The single-stage buccal mucosal flap is a useful technique in CP repair and appears to have minimal negative effects on dental hygiene and no observed significant impact on dental eruption.