Browsing by Author "Goit, Bipulesh"
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Publication Pedicled Buccal Fat Pad versus Conventional Gelfoam in Management of Lateral Palatal Defect Healing After Primary Palatoplasty(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Singh, Sunil Kumar; Goit, Bipulesh; Thapa, Swosti; Pradhan, Leeza; Shakya, PramilaAbstract: Introduction: Delayed mucosalization of lateral palatal defects following palatoplasty may increase postoperative pain, discomfort, and risk of complications. The pedicled buccal fat pad has been used as a biological dressing to enhance intraoral wound healing; however, systematic evaluation following palatoplasty remains limited. This study aimed to evaluate mucosalization time of buccal fat pad-covered lateral palatal defects and compare outcomes with conventional management. Methods: An observational study was conducted at Kirtipur Hospital, Nepal, from August 2025 to January 2026. Thirty non-syndromic cleft palate patients undergoing primary palatoplasty were enrolled consecutively and divided into two groups: Group A (n=15), managed with purified gelatin (Gelfoam), and Group B (n=15), managed with pedicled buccal fat pad coverage. Postoperative pain, cheek swelling, operative duration, and time to complete mucosalization were assessed. Data were analyzed using descriptive statistics, chi-square test, and independent t-test. Results: Baseline demographic characteristics, defect size, and operative duration were comparable between groups. Mean time to complete mucosalization was significantly shorter in the BFP group (2.20 ± 0.41 weeks) than the conventional group (4.00 ± 1.07 weeks; p<0.05). Postoperative pain on the day of surgery was significantly lower in the BFP group, while no postoperative bleeding was observed. Transient cheek swelling in some BFP cases resolved spontaneously. Conclusion: The pedicled buccal fat pad significantly accelerates mucosalization of lateral palatal defects and reduces early postoperative pain without adding substantial operative time. It is a safe and effective adjunct in cleft palate reconstruction.Publication Radiographic Assessment of Secondary Autogenous Bone Grafting in Alveolar Cleft Patient at Kirtipur Hospital(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Goit, Bipulesh; Singh, Sunil Kumar; Thapa, Swosti; Pradhan, Leeza; Shakya, PramilaAbstract: Introduction: Alveolar bone graft is the procedure to fill the gap in the gum with bone so the teeth and jaw can grow normally. It is an integral part and most commonly performed procedure in cleft patients. The study is aimed to evaluate the outcomes of secondary alveolar bone grafting through bone fill at alveolar defect site using 2- dimensional radiographs. Methods: We conducted a single center prospective cohort study at Kirtipur Hospital, Nepal from July 1st, 2025 to December 30th, 2025. Patients who underwent alveolar bone graft were evaluated for outcome of grafting through bone fill seen on intra oral radiographs using Kindelan score grading at 3-4 months post operatively. Outcomes were dichotomized as successful (Kindelan score 1–2) and failure (Kindelan score 3–4). Results: We had a total of 16 cases with 6 males (37.5%) and 10 female (62.5%) patients who had a median age 15.5 years (IQR 11.5, 18). Radiographic success as defined by Kindelan score 1–2 was achieved in 12 cases (75.0%) and failure in 4 cases (25%) with no statistically significant association between sex and radiographic success (p = 0.234). There was good to excellent intra-observer agreement (ICC = 0.89 & 0.96 for observer 1 & 2) and excellent inter-observer reliability (ICC = 0.96). Conclusion: Secondary autogenous alveolar bone grafting demonstrated favorable early radiographic outcomes, with 75% of patients achieving satisfactory bone fill at 3–4 months postoperatively. The Kindelan scoring system proved to be a reliable and reproducible method for radiographic evaluation