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Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, Husein A, Ahmad WMAW, Eusufzai SZ, Prasadh S, Subramaniyan V, Fuloria NK, Fuloria S, Sekar M, Selvaraj S. Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710860. [PMID: 36078576 PMCID: PMC9518587 DOI: 10.3390/ijerph191710860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved. MATERIALS AND METHODS An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied. RESULTS Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis. CONCLUSIONS Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.
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Affiliation(s)
- Mohamed Zahoor Ul Huqh
- Orthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging Lab, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Qazi Farah Rashid
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Adam Husein
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Wan Muhamad Amir W. Ahmad
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Somasundaram Prasadh
- National Dental Center Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
| | | | | | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh 30450, Malaysia
| | - Siddharthan Selvaraj
- Faculty of Dentistry, AIMST University, Bedong 08100, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
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Alam MK, Alfawzan AA, Haque S, Mok PL, Marya A, Venugopal A, Jamayet NB, Siddiqui AA. Sagittal Jaw Relationship of Different Types of Cleft and Non-cleft Individuals. Front Pediatr 2021; 9:651951. [PMID: 34026687 PMCID: PMC8132962 DOI: 10.3389/fped.2021.651951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/06/2021] [Indexed: 01/19/2023] Open
Abstract
To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.
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Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontic Division, Department of Preventive Dental Science, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia
| | | | - Pooi Ling Mok
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Anand Marya
- Section of Orthodontics, University of Puthisastra, Phnom Penh, Cambodia
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Ammar A Siddiqui
- Department of Community Dentistry, College of Dentistry, Bakhtawar Amin Medical and Dental College, Multan, Pakistan
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Haque S, Khamis MF, Alam MK, Wan Ahmad AWM. The Assessment of 3D Digital Models Using GOSLON Yardstick Index: Exploring Confounding Factors Responsible for Unfavourable Treatment Outcome in Multi-Population Children With UCLP. Front Pediatr 2021; 9:646830. [PMID: 34262887 PMCID: PMC8273310 DOI: 10.3389/fped.2021.646830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/28/2021] [Indexed: 11/13/2022] Open
Abstract
To evaluate dental arch relationship (DAR) using GOSLON Yardstick and also to explore the association between multiple factors (age, gender, UCLP types, UCLP side, Family history of cleft, family history of Class III malocclusion, techniques of cheiloplasty, techniques of palatoplasty) and DAR in children unilateral cleft lip and palate (UCLP) in different populations. Two hundred fifty-five laser scanned 3D digital models (LS3DM) of UCLP children (5-12 years) from Malaysia, Bangladesh, and Pakistan were included. The intra- and inter-examiner agreements were evaluated by kappa statistics, to compare the GOSLON mean score between the populations and to explore the responsible factors that affect DAR, one way ANOVA, and crude logistic regression analysis was used, respectively. The mean GOSLON score was 2.97; 3.40 and 3.09 in Malaysia, Bangladesh, and Pakistan, respectively. Twenty seven, 40, and 30 subjects were in unfavourable (category rating 4 and 5) groups in Malaysia, Bangladesh, and Pakistan, respectively. A significant association was found between techniques of palatoplasty (p = 0.03; p = 0.04 and p = 0.04 in Malaysia, Bangladesh, and Pakistan, respectively) and unfavourable DAR. Different cheiloplasty techniques (p = 0.04) and gender (p = 0.03) also exhibited noteworthy associations with unfavourable DAR in the Bangladeshi population. Bardach techniques of palatoplasty were significantly associated with unfavourable DAR in all three populations. Moreover, male UCLP and modified Millard techniques of cheiloplasty were also associated with unfavourable DAR in the Bangladeshi population.
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Affiliation(s)
- Sanjida Haque
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Mohd Fadhli Khamis
- Oral Biology and Forensic Odontology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Forensic Odontology Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
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Alam MK, Alfawzan AA. Dental Characteristics of Different Types of Cleft and Non-cleft Individuals. Front Cell Dev Biol 2020; 8:789. [PMID: 32984313 PMCID: PMC7477047 DOI: 10.3389/fcell.2020.00789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022] Open
Abstract
Objective The objective of this study was to compare the novel artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis of 14 different dental characteristics (DC) among different types of cleft lip and palate (CLP) and non-cleft (NC) individuals. Materials and Methods A retrospective study was conducted on 123 individuals [31 = NC, 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), and 13 = UCL (unilateral cleft lip)] with an average age of 14.77 years. Demographic details were gathered from the clinical records. A novel artificial intelligence-driven Webceph software has been used for the Late. Ceph. analysis. A total of 14 different types of angular and linear DC measurements were analyzed and compared among groups. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of CLP versus NC subjects. Results Of the 14 DC tested, no significant gender disparities were found (p > 0.05). In relation to different types of CLP versus NC subjects, 8 over 14 DC were statistically significant (p < 001 to p = 0.03). Six other DC variables show insignificant (p > 0.05) noteworthy alterations in relation to type of CLP. Conclusion Based on the results, type of CLP revealed significantly altered DC compared to NC. Among different types of CLP, BCLP exhibited a maximum alteration in different DC.
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Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontic Division, Department of Preventive Dental Science, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia
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Arshad AI, Alam MK, Khamis MF. Dentoalveolar Cleft Treatment Outcome Using Modified Huddart-Bodenham Index and Regression Analysis of Associated Factors. Cleft Palate Craniofac J 2018. [PMID: 29518343 DOI: 10.1177/1055665618758278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome. DESIGN Retrospective observational study. SETTING Two regional cleft-referral centers. MAIN OUTCOME MEASURES In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score. RESULTS According to MHB, a mean (standard deviation) total occlusion score of -8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables-gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty-were analyzed with a logistic regression model. CONCLUSIONS Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.
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Affiliation(s)
- Anas Imran Arshad
- 1 School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Kubang Kerian, Malaysia.,4 Operative Dentistry Department, Rashid Latif Dental College, Lahore, Pakistan
| | - Mohammad Khursheed Alam
- 2 Orthodontic Department, College of Dentistry, Al Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Mohammad Fadhli Khamis
- 3 Forensic Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Kubang Kerian, Malaysia
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Haque S, Alam MK, Khamis MF. Treatment Outcome of Bangladeshi UCLP Patients Based on Both Phenotype and Postnatal Treatment Factors using Modified Huddart Bodenham (mHB) Index. Cleft Palate Craniofac J 2018; 55:966-973. [PMID: 27479096 DOI: 10.1597/15-293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the dental arch relationship (DAR) of nonsyndromic unilateral cleft lip and palate (UCLP) and to explore the various phenotype and postnatal treatment factors that are responsible for poor DAR. DESIGN Retrospective study. SETTING School of Dental Science, Universiti Sains Malaysia. SUBJECTS Eighty-four Bangladeshi children with nonsyndromic UCLP who received cheiloplasty and palatoplasty. MAIN OUTCOME MEASURES Dental models were taken at 5 to 12 years of age (man: 7.69), and dental arch relationships were assessed using modified Huddart/Bodenham index (mHB) by two raters. Kappa statistics was used to evaluate the intra- and interexaminer agreements, chi-square was used to assess the associations, and logistic regression analysis was used to explore the responsible factors that affect DAR. RESULTS The total mHB score (mean [SD]) was -8.261 (7.115). Intra- and interagreement was very good. Using crude and stepwise backward regression analysis, significant association was found between positive history of class III (P = .025, P = .030, respectively) and unfavorable DAR. Complete UCLP (P = .003) was also significantly correlated with unfavorable DAR. CONCLUSION This multivariate study suggested complete type of UCLP and positive history of class III had a significantly unfavorable effect on the DAR.
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Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors. Int J Pediatr Otorhinolaryngol 2017; 100:91-95. [PMID: 28802394 DOI: 10.1016/j.ijporl.2017.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/20/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome. MATERIALS AND METHODS It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology. RESULTS A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome. CONCLUSIONS Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes.
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Factors Responsible for Unfavorable Dental Arch Relationship in non Syndromic Unilateral Cleft Lip and Palate Children. J Clin Pediatr Dent 2017; 41:236-242. [PMID: 28422603 DOI: 10.17796/1053-4628-41.3.236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Multiple factors are whispered to be crucial cause of unfavourable dental arch relationship in cleft lip and palate (CLP).This study aims to evaluate the dental arch relationship of Bangladeshi children with non syndromic unilateral cleft lip and palate (UCLP) following cheiloplasty and palatoplasty. Also to explore the various congenital (UCLP type, UCLP side, family history of cleft, family history of class III) and environmental (cheiloplasty, palatoplasty) factors that affects dental arch relationship of UCLP patients. STUDY DESIGN This was a retrospective study where 84 dental models were taken before orthodontic treatment and alveolar bone grafting. The mean age was 7.69± 2.46 (mean± SD). The dental arch relationship was assessed by GOSLON (Great Ormond Street, London and Oslo) Yardstick. According to GOSLON Yardstick, five categories are rated; named- 1: excellent; 2: good; 3: fair; 4: poor; 5: very poor. Also the groups have been dichotomized into favorable (category ratings 1-3) and unfavorable (category ratings 4 and 5) groups. Kappa statistics was used to evaluate the intra- and inter-examiner agreements and logistic regression analysis was used to explore the responsible factors that affect dental arch relationship. RESULTS Total 37 subjects (44% of all subjects) were categorized into unfavourable group (category rating 4 and 5) using GOSLON yardstick. Intra- and inter-examiner agreements were very good. The mean GOSLON score was 3.238. Using crude and stepwise backward regression analysis, significant association was found between family history of skeletal class III malocclusion (p = 0.015 and p = 0.014 respectively) and unfavourable dental arch relationship. Complete UCLP (p = 0.054) and left sided UCLP (p = 0.053) also seemed to be correlated but not significant with unfavourable dental arch relationship using crude and stepwise backward regression analysis respectively. CONCLUSION This analysis suggested that family history of skeletal class III was significantly correlated with unfavourable dental arch relationship of Bangladeshi UCLP children.
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Haque S, Alam MK, Khamis MF. The effect of various factors on the dental arch relationship in non-syndromic unilateral cleft lip and palate children assessed by new approach: a retrospective study. BMC Pediatr 2017; 17:119. [PMID: 28477625 PMCID: PMC5420398 DOI: 10.1186/s12887-017-0870-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 04/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background Cleft lip and palate (CLP) is one of the most common birth defects. Multiple factors are believed to be responsible for an unfavorable dental arch relationship in CLP. Facial growth (maxillary) retardation, which results in class III malocclusion, is the primary challenge that CLP patients face. Phenotype factors and postnatal treatment factors influence treatment outcomes in unilateral cleft lip and palate (UCLP) children, which has led to a great diversity in protocols and surgical techniques by various cleft groups worldwide. The aim of this study was to illustrate the dental arch relationship (DAR) and palatal morphology (PM) of UCLP in Bangladeshi children and to explore the various factors that are responsible for poor DAR and PM. Methods Dental models of 84 subjects were taken before orthodontic treatment and alveolar bone grafting. The mean age was 7.69 (SD 2.46) years. The DAR and PM were assessed blindly by five raters using the EUROCRAN index (EI). Kappa statistics was used to evaluate the intra- and inter-examiner agreement, chi square was used to assess the associations, and logistic regression analysis was used to explore the responsible factors that affect DAR and PM. Results The mean EUROCRAN scores were 2.44 and 1.93 for DAR and PM, respectively. Intra- and inter-examiner agreement was moderate to very good. Using crude and stepwise backward regression analyses, significant associations were found between the modified Millard technique (P = 0.047, P = 0.034 respectively) of cheiloplasty and unfavorable DAR. Complete UCLP (P = 0.017) was also significantly correlated with unfavorable DAR. The PM showed a significant association with the type of cleft, type of cheiloplasty and type of palatoplasty. Conclusion This multivariate study determined that the complete type of UCLP and the modified Millard technique of cheiloplasty had significantly unfavorable effects on both the DAR and PM.
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Affiliation(s)
- Sanjida Haque
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Department, College of Dentistry, Al Jouf University, Sakaka, Kingdom of Saudi Arabia.
| | - Mohd Fadhli Khamis
- Forensic Dentistry/Oral Biology Unit, School of Dental Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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Arshad AI, Alam MK, Khamis MF. Assessment of complete unilateral cleft lip and palate patients: Determination of factors effecting dental arch relationships. Int J Pediatr Otorhinolaryngol 2017; 92:70-74. [PMID: 28012538 DOI: 10.1016/j.ijporl.2016.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of the current study was to assess the treatment outcome of non-syndromic patients having complete unilateral cleft lip and palate (CUCLP) by using GOSLON index and to determine any association of pre and/or postnatal factors with the treatment outcome. MATERIALS AND METHODS One hundred and one sets of dental models of patients having CUCLP were assessed in this retrospective study. Five examiners that were blinded to case-specific information scored the dental models at two instances with an interval of two weeks to ensure memory bias elimination (5 × 101 × 2 = 1010 observations). Calibration courses were conducted prior to scoring and each examiner was provided with scoring sheets, pictures of GOSLON reference models and flowcharts explaining the scoring method. RESULTS According to GOSLON index, a mean (SD) GOSLON score of 3.04 (1.25) was determined. Based on treatment outcome groups, 62 patients had favorable (grade 1, 2, and 3) and 39 cases had unfavorable (grade 4 and 5) treatment outcome. Chi-square tests revealed a significant association of gender (P = 0.002), cheiloplasty (P = 0.001) and palatoplasty (P < 0.001) with the treatment outcome. These associations were further explored by entering five independent variables in the logistic regression models. CONCLUSIONS The current study found an intermediate treatment outcome of CUCLP cases using GOSLON index. Final logistic model showed that gender, cheiloplasty, and palatoplasty had significantly higher odds of influencing outcomes. Identification of these factors provides us an evidence of traditional and outdated surgical methods and encourages clinicians to adopt current techniques to improve treatment outcomes. This implementation will facilitate comparison between the traditional and current techniques of primary surgical repair.
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Affiliation(s)
- Anas Imran Arshad
- School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
| | | | - Mohd Fadhli Khamis
- Forensic Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Zin MNM, Alam MK, Haque S, Imanishi T, Toriya J, Osuga N, Razak NHA. The Assessment of Treatment Outcome by Evaluation of Dental Arch Relationships in Unilateral Cleft Lip and Palate Children using mHB Scoring System. J HARD TISSUE BIOL 2017. [DOI: 10.2485/jhtb.26.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mazida Najwa Md. Zin
- Department of Oral and Maxillofacial Surgery, School of Dental Science, Universiti Sains Malaysia
| | | | - Sanjida Haque
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia
| | - Tohru Imanishi
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Jin Toriya
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Naoto Osuga
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Noor Hayati Abd. Razak
- Department of Oral and Maxillofacial Surgery, School of Dental Science, Universiti Sains Malaysia
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Yew CC, Alam MK, Rahman SA. Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study. Int J Pediatr Otorhinolaryngol 2016; 89:42-9. [PMID: 27619027 DOI: 10.1016/j.ijporl.2016.07.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 06/22/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis. METHOD A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis. RESULT Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome. CONCLUSIONS This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general.
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Affiliation(s)
- Ching Ching Yew
- Oral and Maxillofacial Surgery Unit, Universiti Sains Malaysia, Kelantan, Malaysia.
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Treatment outcome after neonatal cleft lip repair in 5-year-old children with unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol 2016; 87:71-7. [PMID: 27368446 DOI: 10.1016/j.ijporl.2016.05.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of this study was to assess speech outcomes and dental arch relationship of 5-year-old Czech patients with unilateral cleft lip and palate (UCLP) who have undergone neonatal cleft lip repair and one-stage palatal closure. METHODS AND MATERIALS Twenty-three patients with UCLP, born between 2009 and 2010, were included in the study. Three universal speech parameters (hypernasality, articulation and speech intelligibility) have been devised for speech recordings evaluation. Outcomes of dental arch relationship were evaluated by applying the GOSLON Yardstick and subsequently compared with the GOSLON outcome of other cleft centers. RESULTS Moderate hypernasality was present in most cases, the mean value for articulation and speech intelligibility was 2.07 and 1.93, respectively. The Kappa values for inter-examiner agreement for all the three speech outcomes ranged from 0.786 to 0.808. Sixty-three percent of patients were scored GOSLON 1 and 2, 26% GOSLON 3, and 10% GOSLON 4. GOSLON mean score was 2.35. Interrater agreement was very good, represented by kappa value of 0.867. CONCLUSION The treatment protocol, involving neonatal cleft lip repair and one-stage palatal repair performed up to the first year of UCLP patient's life, has shown good speech outcomes and produced very good treatment results in regard to maxillary growth, comparable with other cleft centers.
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Ahmed Asif J, Khursheed Alam M, Imanishi T, Mukai A, Yusa T, Haque S, Pohchi A. Treatment Outcome and Factors Affecting Dental Arch Relationship in Malay Children with Unilateral Cleft Lip and Palate (UCLP). J HARD TISSUE BIOL 2016. [DOI: 10.2485/jhtb.25.371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jawaad Ahmed Asif
- Department of Oral and Maxillofacial Surgery, School of Dental Science, Universiti Sains Malaysia
| | | | - Tohru Imanishi
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Ayako Mukai
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Tatsunori Yusa
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Sanjida Haque
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia
| | - Abdullah Pohchi
- Department of Oral and Maxillofacial Surgery, School of Dental Science, Universiti Sains Malaysia
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Suzuki A, Sasaguri M, Hiura K, Yasunaga A, Mitsuyasu T, Kubota Y, Ninomiya T, Takenoshita Y. Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology? Cleft Palate Craniofac J 2014; 51:696-706. [DOI: 10.1597/12-103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.
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Affiliation(s)
- Akira Suzuki
- Department of Orthodontics, Kyushu University Hospital, Fukuoka, Japan
| | - Masaaki Sasaguri
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
| | | | - Atsushi Yasunaga
- Department of Orthodontics, Kyushu University Hospital, Fukuoka, Japan
| | - Takeshi Mitsuyasu
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
| | - Yasutaka Kubota
- Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Tomohiro Ninomiya
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
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