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Achterrath S, Graf I, Guevara R, Braumann B, Kruse T. Predictors for long-term relapse of orthodontic treatment in patients with cleft lip and palate. A clinical follow-up study. Clin Oral Investig 2024; 28:239. [PMID: 38568324 PMCID: PMC10991025 DOI: 10.1007/s00784-024-05632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To identify predictors for long-term relapse of orthodontic therapy in patients with cleft lip and palate (CLP). MATERIALS AND METHODS Patients with uni- and bilateral non-syndromal CLP were followed up at least two years after completion of their orthodontic therapy. Plaster casts of the start of treatment (T1), after completion of treatment (T2), and at follow-up (T3) were measured using the modified Huddart Bodenham Index. Characteristics of multidisciplinary therapy were taken from the patient files. Potentially influencing factors of relapse were investigated using logistic regression analyses and Spearman correlations. RESULTS In total 58.07% of the included 31 patients showed a stable treatment outcome at follow-up after an average of 6.9 years. Even if relapse occurred, 61.54% of these patients still showed improvement regarding their occlusion compared to baseline. Predictors for the occurrence of relapse were the severity of dysgnathia at baseline (p = 0.039) and the extent of therapeutic change (p = 0.041). The extent of therapeutic change was additionally a predictor for the extent of post-therapeutic relapse (ρ = 0.425; p = 0.019). CONCLUSIONS Patients with CLP benefit from their orthodontic therapy in the long term despite an increased tendency to relapse. CLINICAL RELEVANCE Results of this long-term study could be used to adapt the treatment concept for patients with CLP and reinforce the significance of a patient-centered orthodontic treatment concept for affected patients.
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Affiliation(s)
- Sarah Achterrath
- Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany.
| | - Isabelle Graf
- Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany
| | - Romeo Guevara
- Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany
| | - Bert Braumann
- Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany
| | - Teresa Kruse
- Department of Orthodontics, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 32, 50937, Cologne, Germany
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2
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Otsuki K, Yamanishi T, Enomoto A, Tanaka S, Kogo M, Tome W, Oonishi-Yamamoto Y, Seikai T. Maxillary Development and Dental Arch Relationships Following Early Two-Stage Palatoplasty: A Comparative Study. Cleft Palate Craniofac J 2024; 61:400-408. [PMID: 36259119 DOI: 10.1177/10556656221129751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine skeletal morphology and dental arch relationships at 8 years of age following early 2-stage palatoplasty, which consists of soft palate plasty at 1 year of age and hard palate closure at 1.5 years of age, and to compare the results with those of conventional pushback palatoplasty. DESIGN Retrospective. SETTING Single institutional study. PATIENTS Eighty-six patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) were selected. INTERVENTION The subjects were divided into 2 groups according to the palatoplasty protocols, as follows: 45 patients, who underwent early 2-stage palatoplasty (ETS group), and 41 patients, who underwent 1-stage pushback palatoplasty (PB group). MAIN OUTCOME MEASURES Skeletal morphology was assessed using lateral cephalometric analysis, and dental arch relationships were examined using the GOSLON yardstick. RESULTS Cephalometric analysis revealed that the anterior-posterior length of the maxilla, measured by PTM-A and PTM-ANS, both projected to the nasal floor (NF) plane, was longer in the ETS group than in the PB group (PTM-A/NF, p = .04; PTM-ANS/NF, p = .03, unpaired t-test), although no significant difference was observed in SNA (p = .09, unpaired t-test). Upper posterior facial height was shorter in the ETS group than in the PB group (p = .02, unpaired t). Assessments with the GOSLON yardstick showed that the ETS group presented better dental arch relationships than the PB group (p = 0.04, Mann-Whitney's U-test). CONCLUSIONS The present results suggested that the ETS protocol reduced the negative effects of palatal surgery on facial development and dental arch relationships in patients with complete UCLP at 8 years of age.
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Affiliation(s)
- Koichi Otsuki
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Tadashi Yamanishi
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Akifumi Enomoto
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kindai University Hospital, Osaka, Japan
| | - Susumu Tanaka
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Mikihiko Kogo
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Wakako Tome
- Department of Orthodontics, Oral Structure, Function, and Development, School of Dentistry, Asahi University, Gifu, Japan
| | - Yuri Oonishi-Yamamoto
- Department of Oral and Maxillofacial Surgery, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Tetsuya Seikai
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
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Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023; 24:987-990. [PMID: 38317397 DOI: 10.5005/jp-journals-10024-3606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM To determine dental arch relationships of Saudi children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS This is a retrospective cohort study that comprised dental study models of 74 UCLP Saudi children aged 8-10 years who were recruited from 14 referral cleft centers. All participants had their cleft lip and palate repaired with no history of alveolar bone graft or any orthodontic treatment. Dental arch relationships of UCLP patients were assessed using the Great Ormond Street, London, and Oslo (GOSLON) Yardstick-a clinical tool that categorizes dental relationships of UCLP children into five discrete grades from I to V. The reliability of the rating was assessed with weighted kappa (κ) statistics. RESULTS Three children (4.1%) had excellent surgical outcomes (grade I), 18 children (24.3%) filled into grade II (good outcome), 22 subjects (29.7%) had grade III (fair outcome), 27 children (36.5%) had grade IV (poor outcome), and 4 subjects (5.4%) were ranked as having very poor outcomes (grade V). The mean GOSLON score was 3.39. Intrarater and interrater agreements were high indicating good reproducibility. CONCLUSION Based on the dental arch relationships, the treatment outcome of UCLP Saudi children was unsatisfactory, with a mean GOSLON score of 3.39. Delayed palate repair and the use of presurgical orthopedics may be considered in the future for cleft deformity management. CLINICAL SIGNIFICANCE To address the effect of particular cleft surgical protocol on dental arch relationships of UCLP patients. How to cite this article: Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023;24(12):987-990.
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Affiliation(s)
- Sahal Alforaidi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Saudi Arabia
| | - Maen Zreaqat
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia, Phone: +60 97673719, e-mail:
| | - Rozita Hassan
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
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4
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Srivastav S, Tewari N, Antonarakis GS, Duggal R, Saji S, Lokade AK, Yadav R. Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate. J Clin Med 2023; 12:6002. [PMID: 37762942 PMCID: PMC10532364 DOI: 10.3390/jcm12186002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. OBJECTIVES To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. SEARCH METHODS The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. SELECTION CRITERIA Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. DATA COLLECTION AND ANALYSIS A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. RESULTS A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. CONCLUSIONS The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. REGISTRATION A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).
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Affiliation(s)
- Sukeshana Srivastav
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Nitesh Tewari
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Gregory S. Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seba Saji
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Amol Kumar Lokade
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rahul Yadav
- Division of Oral and Maxillofacial Surgery, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India
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5
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Defabianis P, Guagnano R, Romano F. A Cross-Sectional Study of the Dental Arch Relationship and Palatal Morphology after Cleft Surgery in Italian Children with Unilateral Cleft and Lip Palate. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1559. [PMID: 37761520 PMCID: PMC10528838 DOI: 10.3390/children10091559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Dental arch relationships (DARs) and palatal morphology (PM) were evaluated in in non-syndromic complete unilateral cleft lip and palate (UCLP) Italian patients after surgery. Pre- and postnatal factors affecting the results were investigated. Sixty-six children with UCLP (40 boys and 26 girls, with a mean age of 10.1 ± 2.9 years), predominantly Caucasian (77%), were consecutively enrolled in this cross-sectional study. Twenty children had received a one-stage protocol consisting of an early periosteal palate surgical repair and lip closure and forty-six were submitted to a staged surgical protocol with delayed palate repair (DPR). A single clinician collected data on their medical history and carried out a dental examination. The DAR and PM were graded on dental casts according to the Eurocran index and dichotomised as favourable and unfavourable based on the treatment outcome. Multiple logistic regression analyses demonstrated that female sex (OR = 6.08, 95% CI: 1.47-25.23, p = 0.013), DPR (OR = 4.77, 95% CI: 1.14-19.93, p = 0.032) and the use of a neonatal plate (OR = 4.68, 95% CI: 1.27-17.16, p = 0.020) increased the odds of having favourable DAR, while only DPR (OR = 9.76, 95% CI: 2.40-39.71, p = 0.001) was significantly associated with a favourable PM. Based on these findings, only DPR had a significantly favourable effect on both DAR and DM in Italian children with complete UCLP.
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Affiliation(s)
- Patrizia Defabianis
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | | | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
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6
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Kuang W, Aarts M, Kuijpers-Jagtman AM, He H, Ongkosuwito EM. Treatment Outcome in Bilateral Cleft lip and Palate Patients Evaluated With the Huddart-Bodenham Scoring System and the Bilateral Cleft lip and Palate Yardstick: A Systematic Review. Cleft Palate Craniofac J 2021; 59:1377-1390. [PMID: 34658258 PMCID: PMC9537448 DOI: 10.1177/10556656211041883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives To assess treatment outcome (transversal and sagittal dental arch
relationships) and its determinants in complete bilateral cleft lip and
palate (BCLP) evaluated with the modified Huddart-Bodenham scoring system
and the BCLP Yardstick. Materials and methods Multiple electronic databases were searched without time limitation.
Randomized clinical trials, cohort and case control studies using BCLP
Yardstick and/or modified Huddart-Bodenham system to judge treatment outcome
of patients with BCLP were included. The Risk of Bias in Nonrandomized
Studies of Interventions tool and Grading of Recommendations, Assessment,
Development, and Evaluation was used. Results Of the 528 studies identified by the electronic search, only eight
retrospective studies met the inclusion criteria and were included. A total
of 12 cleft centers were represented. All treatment protocols differed and
background information was underreported. The results for the BCLP yardstick
showed that all except the centers in New Zealand had a mean score lower
than 3, indicating good treatment results. However, these studies had a
moderate to high risk of bias. The modified Huddart-Bodenham scores were
negative in all studies. No further meta-analysis was done due to
heterogeneity and high risk of bias. The quality of evidence was graded as
very low. Conclusion Results for the dental arch relationship of studies in complete BCLP and
possible determinants were not synthesized due to very low quality of
evidence. Clinical research for patients with BCLP should focus on sound
methodological designs to enable evidence-based decision making to improve
treatment for patients with BCLP and thereby hopefully their quality of
life.
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Affiliation(s)
- Wenying Kuang
- School & Hospital of Stomatology, 499766Wuhan University, Wuhan, China.,Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
| | - Miranda Aarts
- Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
| | - Anne Marie Kuijpers-Jagtman
- University Medical Center Groningen, 10173University of Groningen, Groningen, the Netherlands.,School of Dental Medicine/Medical Faculty, 27210University of Bern, Bern, Switzerland; Universitas Indonesia, Jakarta, Indonesia
| | - Hong He
- School & Hospital of Stomatology, 499766Wuhan University, Wuhan, China
| | - Edwin M Ongkosuwito
- Radboud University Medical Center, 6034Radboud University, Nijmegen, the Netherlands
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7
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Heliövaara A, Küseler A, Skaare P, Bellardie H, Mølsted K, Karsten A, Marcusson A, Rizell S, Brinck E, Sæle P, Chalien MN, Mooney J, Eyres P, Shaw W, Semb G. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: comparison of dental arch relationships and dental indices at 5, 8, and 10 years. Eur J Orthod 2021; 44:258-267. [PMID: 34476476 PMCID: PMC9127717 DOI: 10.1093/ejo/cjab055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and trial design The Scandcleft intercentre study evaluates the outcomes of four surgical protocols (common method Arm A, and methods B, C, and D) for treatment of children with unilateral cleft lip and palate (UCLP) in a set of three randomized trials of primary surgery (Trials 1, 2, and 3). Objectives To evaluate and compare dental arch relationships of 5-, 8-, and 10-year-old children with UCLP after four different protocols of primary surgery and to compare three dental indices. The results are secondary outcomes of the overall trial. Methods Study models taken at the ages of 5 (n = 418), 8 (n = 411), and 10 years (n = 410) were analysed by a blinded panel of orthodontists using the Eurocran index, the 5-year-olds’ (5YO) index, and the GOSLON Yardstick. Student’s t-test, Pearson’s correlation, chi-square test, and kappa statistics were used in statistical analyses. Results The reliability of the dental indices varied between moderate and very good, and those of the Eurocran palatal index varied between fair and very good. Significant correlations existed between the dental indices at all ages. No differences were found in the mean 5-, 8-, and 10-year index scores or their distributions within surgical trials. Comparisons between trials detected significantly better mean index scores in Trial 2 Arm C (at all ages) and in Trial 1 Arm B (at 5 and 10 years of age) than in Trial 3 Arm D. The mean Eurocran dental index scores of the total material at 5, 8, and 10 years of age were 2.50, 2.60, and 2.26, and those of the 5YO index and GOSLON Yardstick were 2.77, 2.90, and 2.54, respectively. At age 10 years, 75.8% of the patients had had orthodontic treatment. Conclusions The results of these three trials do not provide evidence that one surgical method is superior to the others. The reliabilities of the dental indices were acceptable, and significant correlations existed between the indices at all ages. The reliability of the Eurocran palatal index was questionable. Trial registration ISRCTN29932826.
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Affiliation(s)
- Arja Heliövaara
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Finland
| | - Annelise Küseler
- Cleft Palate Center and University Hospital Aarhus and University of Aarhus, Denmark
| | - Pål Skaare
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Haydn Bellardie
- Dental School, University of Manchester, UK.,University of the Western and Cape, Cape Town, South Africa
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | - Agneta Karsten
- Section for Orthodontics, Division of Orthodontics and Pedodontics, Department of Dental Medicine, Karolinska Institutet and Stockholm Craniofacial Team, Sweden
| | - Agneta Marcusson
- Maxillofacial Unit and Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Sara Rizell
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | - Eli Brinck
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Paul Sæle
- Oral Health Center of Expertise/Western Norway, Bergen, Norway
| | - Midia Najar Chalien
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | | | - Phil Eyres
- Dental School, University of Manchester, UK
| | | | - Gunvor Semb
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.,Dental School, University of Manchester, UK
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8
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Staudt CB, Bollhalder J, Eichenberger M, La Scala G, Herzog G, Wiedemeier DB, Antonarakis GS. Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 59:899-909. [PMID: 34235980 PMCID: PMC9260490 DOI: 10.1177/10556656211028506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To evaluate final posttreatment occlusion in patients with complete
unilateral cleft lip and palate (cUCLP) by comparing (1) 3
treatment centers, (2) males and females, (3) cleft and noncleft
sides, (4) right- and left-sided clefts, and (5) orthodontic
treatment with/without orthognathic surgery (OS). Design: Retrospective cohort study. Patients: Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4
years) with cUCLP from 3 centers in Switzerland. Main Outcome Measure: Occlusal assessment using the modified Huddart/Bodenham (MHB)
index. Results: Our sample comprised 35 males and 21 females, 46 with left- and 10
with right-sided clefts, of which 32 had undergone OS. The final
posttreatment occlusion showed a median MHB score of 0
(interquartile range: −1.0 to 2.0) in the total sample and did
not seem to depend on treatment center, sex, or OS. The MHB
scores for the anterior buccal and the buccal segments were more
negative on the cleft than on the noncleft side
(P = .002 and P = .006,
respectively). When the cleft was on the left side, the MHB
score tended to be more positive in the labial
(P = .046) and anterior buccal segments
(P = .034). Conclusions: This study shows a very satisfactory final posttreatment occlusion
in patients with cUCLP. The more constricted buccal occlusion on
the cleft side emphasizes the attention that should be given in
correcting the more medially positioned lesser maxillary
segment. The influence of cleft-sidedness should be analyzed
further on a sample including more patients with right-sided
clefts.
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Affiliation(s)
- Christine B Staudt
- Cleft Lip and Palate Unit, Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Julia Bollhalder
- Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Martina Eichenberger
- Division of Orthodontics, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Giorgio La Scala
- Division of Pediatric Surgery, Children's Hospital, University of Geneva, University Centre of Pediatric Surgery of Western Switzerland, Geneva, Switzerland
| | - Georges Herzog
- Division of Orthodontics, University Clinic of Dental Medicine, University of Geneva, Switzerland.,University Hospital CHUV, Lausanne, Switzerland
| | - Daniel B Wiedemeier
- Statistical Services, Centre of Dental Medicine, University of Zurich, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinic of Dental Medicine, University of Geneva, Switzerland
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9
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Miura S, Ueda H, Iwai K, Concepcion Medina C, Ishida E, Kunimatsu R, Tanimoto K. Masticatory Function Assessment of Adult Patients With Cleft Lip and Palate After Orthodontic Treatment. Cleft Palate Craniofac J 2021; 59:390-398. [PMID: 33576265 DOI: 10.1177/1055665621991733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To determine whether orthodontically treated patients with cleft lip and palate (CLP) possess a different masticatory function than those of untreated patients with normal occlusion. DESIGN Occlusal contact area, occlusal force, as well as masseter and anterior temporal muscular activity were measured during maximum voluntary clenching (MVC) tests. Mandibular left and right lateral movements during mastication were also assessed. To further elucidate the nature of masticatory function, especially to determine the rate of abnormal jaw movement patterns, a parametric error index (EI) was set. Finally, masticatory efficiency was evaluated with a glucose sensitive measuring device. PARTICIPANTS Fifteen patients with CLP who had previously completed the orthodontic treatments required to achieve an acceptable and more harmonious occlusion accepted to volunteer in this study along with 21 untreated patients who already possessed a normal occlusion. RESULTS Patients with CLP showed a significantly lower occlusal force, reduced occlusal contact area, and decreased masticatory efficiency as well as significantly higher EI value when compared with controls. However, there was no significant difference when analyzing muscle activity, although masticatory efficiency was significantly different between the 2 groups. Despite this result, the scores obtained by the patients with CLP in the masticatory efficiency tests were still in the normal range. CONCLUSIONS Orthodontic treatment for adult patients with CLP provides a satisfactory result for the patients' masticatory ability albeit significantly less ideal compared with untreated patients with normal occlusion.
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Affiliation(s)
- Sayumi Miura
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroshi Ueda
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Koji Iwai
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, Hiroshima, Japan
| | - Cynthia Concepcion Medina
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, Hiroshima, Japan
| | - Eri Ishida
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, Hiroshima, Japan
| | - Ryo Kunimatsu
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, Hiroshima, Japan
| | - Kotaro Tanimoto
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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10
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Heliövaara A, Leikola J. Prediction of orthognathic surgery need in children with unilateral cleft lip palate: Dental arch relationships and 5-year-olds' index. Orthod Craniofac Res 2021; 24:528-535. [PMID: 33440074 DOI: 10.1111/ocr.12467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/29/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate whether dental arch relationships at 6 years of age can categorize treatment outcome and predict later need for orthognathic surgery in children with unilateral cleft lip and palate (UCLP). SETTING AND SAMPLE POPULATION A retrospective longitudinal single-centre study. The study sample comprised 70 consecutive non-syndromic children (47 boys) with complete UCLP operated on by pushback techniques during 1981-1989 and followed until early adulthood in the same cleft centre. MATERIALS AND METHODS Dental casts and maxillomandibular relationships were assessed before orthodontic treatment and secondary alveolar bone grafting at mean age 6.1 years (range 5.6-6.8) using the 5-year-olds' index and lateral cephalograms. The need for orthognathic surgery was retrieved from patient files. Student's t test, Pearson's correlation, and Kappa statistics were used in statistical analyses. RESULTS Orthognathic surgery frequency was 41% (29/70). Those needing orthognathic surgery comprised all 3 patients with an index score of 5 (very poor), 14 of 17 (82%) scoring 4 (poor), 10 of 26 (38%) scoring 3 (fair), and 2 of 19 (11%) scoring 2 (good). Of the five patients with index score 1 (excellent), none needed osteotomies. The mean index score was 2.9. The score was significantly better in those without orthognathic surgery (2.4 versus 3.6). A significant negative correlation existed between the 5-year-olds' index and cephalometric angles ANB and anb. CONCLUSION The use of 5-year-olds' index may help to predict treatment outcome and the clinical need for orthognathic surgery especially in patients with the lowest and highest index scores.
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Affiliation(s)
- Arja Heliövaara
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland
| | - Junnu Leikola
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Helsinki, Finland
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11
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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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12
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Pegelow M, Klintö K, Stålhand G, Lemberger M, Vesterbacka M, Rizell S, Chalien MN, Björnström L, Becker M, Lindberg M, Marcusson A, Karsten A. Validation of reported dentoalveolar relationships in the Swedish Quality Registry for Cleft Lip and Palate. Eur J Orthod 2020; 42:30-35. [PMID: 31586178 DOI: 10.1093/ejo/cjz069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The present study validated data that had been reported to the Swedish Quality Registry for Cleft Lip and Palate (CLP) under new requirements from 2016, when use of the 5-year-old (5YO) and the Modified Huddart and Bodenham (MHB) indices for rating occlusion in children born with unilateral CLP (UCLP) was introduced. MATERIALS AND METHODS The sample included blinded study casts (n = 97) and photos (n = 4) of 5-year-old children who had been born with UCLP in 2009-2011 and were enrolled at one of six cleft centres in Sweden. Fourteen orthodontists from the centres assessed the patients (n = 101) using the 5YO and the MHB indices. Median 5YO and MHB scores of the 14 assessments were compared with original registry data (n = 61). Each centre devised code keys to protect the identities of their patients in the registry. RESULTS Interrater agreement among the 14 orthodontists was good for the 5YO index (quadratic-weighted kappa: 0.72-0.92) and the MHB index (intraclass correlation coefficient: 0.991-0.994). Comparisons of median 5YOs for each identifiable child with their registry data (n = 61) found total agreement for 70.5 per cent. Comparisons between median MHBs and registry data showed very good or good agreement in 93.4 per cent of the cases. LIMITATIONS Two teams lost their code keys, which reduced the sample to 61 patients. CONCLUSIONS The dentoalveolar outcome data in the CLP registry was trustworthy. There was good agreement among the Swedish cleft teams assessing the 5YO and MHB indices in children born with UCLP at age 5 years.
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Affiliation(s)
- Marie Pegelow
- Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm
| | - Kristina Klintö
- Department of Otorhinolaryngology, Division of Speech and Language Pathology, Skåne University Hospital, Malmö
| | - Gudrun Stålhand
- Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University Hospital, Malmö
| | - Mathias Lemberger
- Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm
| | - Malin Vesterbacka
- Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm
| | - Sara Rizell
- Department of Odontology, Sahlgrenska Academy, University of Gothenburg
| | | | | | - Magnus Becker
- Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden
| | | | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University Hospital, Malmö
| | - Agneta Karsten
- Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm
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13
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Heliövaara A, Skaare P, Küseler A, Shaw W, Mølsted K, Karsten A, Marcusson A, Brinck E, Rizell S, Sæle P, Najar Chalien M, Bellardie H, Mooney J, Eyres P, Semb G. Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate. Dental arch relationships in 8 year-olds. Eur J Orthod 2020; 42:1-7. [PMID: 31579909 DOI: 10.1093/ejo/cjz067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND TRIAL DESIGN The Scandcleft intercentre study evaluates the outcomes of four surgical protocols for treatment of children with unilateral cleft lip and palate (UCLP). Originally 10 cleft centres in Denmark, Finland, Norway, Sweden, and the UK participated in a set of three randomized trials of primary surgery. Three groups of centres (Trials 1, 2, and 3) tested their traditional local surgical protocols (Arms B, C, and D) against a common protocol (Arm A). OBJECTIVES To evaluate dental arch relationships at age 8 years after four different protocols of primary surgery for UCLP. These results are secondary outcomes of the overall trial. METHODS Study models of 411 children (270 boys, 141 girls) with non-syndromic UCLP at a mean age of 8.1 (range 7.0-10.0) years were available. Dental arch relationships were analysed using the GOSLON Yardstick by a blinded panel of 11 orthodontists. To assess reliability, Kappa statistics were calculated. The trials were tested statistically with t-tests. RESULTS Comparisons within each trial showed no statistically significant differences in the mean 8-year index scores or their distributions between the common protocol and the local team protocol. The mean index scores were Trial 1: Arm A 3.03, Arm B 2.82, Trial 2: Arm A 2.78, Arm C 2.64, and Trial 3: Arm A 3.06, Arm D 3.08. Comparisons between the trials detected a significantly (P < 0.005) better mean index score Trial 2 Arm C than in Trial 3 Arm D. The intra- and inter-rater reliabilities were acceptable. CONCLUSION The results of these three trials do not provide evidence that one surgical protocol is better than the others. TRIAL REGISTRATION ISRCTN29932826.
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Affiliation(s)
- Arja Heliövaara
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, Finland
| | - Pål Skaare
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Annelise Küseler
- Cleft Palate Center and University Hospital Aarhus and University of Aarhus, Denmark
| | | | - Kirsten Mølsted
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Denmark
| | - Agneta Karsten
- Section for Orthodontics, Division of Orthodontics and Pedodontics, Department of Dental Medicine, Karolinska Institutet and Stockholm Craniofacial Team, Sweden
| | - Agneta Marcusson
- Maxillofacial Unit and Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Eli Brinck
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway
| | - Sara Rizell
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | - Paul Sæle
- Oral Health Center of Expertise/Western Norway, Bergen, Norway
| | - Midia Najar Chalien
- Specialist Clinic for Orthodontics, University Clinics of Odontology, Public Dental Health Service, Västra Götaland Region, Sweden
| | - Haydn Bellardie
- Dental School, University of Manchester, UK.,The University of the Western Cape, South Africa
| | | | - Phil Eyres
- Dental School, University of Manchester, UK
| | - Gunvor Semb
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Norway.,Dental School, University of Manchester, UK
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14
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Botticelli S, Küseler A, Mølsted K, Ovsenik M, Nørholt SE, Dalstra M, Cattaneo PM, Pedersen TK. Palatal morphology in unilateral cleft lip and palate patients: Association with infant cleft dimensions and timing of hard palate repair. Orthod Craniofac Res 2019; 22:270-280. [PMID: 31056824 DOI: 10.1111/ocr.12318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/05/2019] [Accepted: 04/26/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the impact of cleft severity and timing of hard palate repair on palatal dimensions in unilateral cleft lip and palate (UCLP) children. SETTING AND SAMPLE POPULATION Single-centre analysis within a multicenter RCT of primary surgery; 122 UCLP randomized to early hard palate closure (EHPC) at 12 months or delayed hard palate closure (DHPC) at 36 months; 28 frequency-matched controls. METHODS Linear measurements of palatal height, width and length were performed on 116 digital models of UCLP subjects (8.21 years, SD = 0.53) and 28 models of non-cleft individuals (8.44 years SD = 0.72). Cleft dimensions at infancy (mean 1.8 months) were considered. In a pilot study, shell-to-shell distances between the 3D cleft palate objects and a reference mesh were calculated and differences between the groups assessed. Morphological differences were visualized using colour mapping. RESULTS Compared to controls, UCLP subjects presented a higher palate at the level of the anterior scar (P = 0.002), but generally a lower palate in the middle region (P < 0.001). Comparing UCLP subgroups, the DHPC subjects showed a flatter palate posteriorly (P = 0.048) and the EHPC group exhibited more transversal constriction (P = 0.003 at M1 level). 3D analysis revealed a shallower palate in the DHPC group both in the middle (P = 0.002) and the posterior part (P = 0.008). Anterior cleft severity correlated negatively with palatal height (P = 0.01). CONCLUSIONS Unilateral cleft lip and palate palates differ from controls in width and height. DHPC may represent an advantage for the transversal dimension, but a disadvantage for palatal height. Infant cleft dimensions partially explain differences in palatal height.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center-University Hospital of Copenhagen, Copenhagen, Denmark
| | - Maja Ovsenik
- Department of Orthodontics and Dentofacial Orthopedics, University of Ljubljana, Ljubljana, Slovenia
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark
| | - Michel Dalstra
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | | | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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15
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Siegenthaler M, Bettelini L, Brudnicki A, Rachwalski M, Fudalej PS. Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients. J Craniomaxillofac Surg 2018; 46:2052-2057. [PMID: 30416034 DOI: 10.1016/j.jcms.2018.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/30/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate the dental arch relationship in preadolescent children with complete unilateral cleft lip and palate after early secondary alveolar bone grafting (E-ABG) by comparing to late bone grafting (L-ABG). MATERIAL AND METHODS Two raters blindly assessed the dental arch relationship with the modified Huddart-Bodenham (HB) Index for 2 groups: E-ABG group (36 children, mean age 9.6 years) and L-ABG group (56 children, mean age 11.1 years). The groups differed with respect to age at which alveolar bone grafting was performed: between 1.4 and 4.1 years (mean 2.2 years, E-ABG group) and after 8 years (L-ABG group). T-test was run to compare scores between 2 groups. Regression analysis was carried out to evaluate gender, age at cleft repair, age at ABG, and age at assessment with the HB index. RESULTS The overall HB scores were -6.77 and -4.25 in the E-ABG and L-ABG groups, respectively (p = 0.025). Regression analysis showed that only the age at cleft repair influenced the HB scores. CONCLUSION ABG carried out between 2 and 4 years of age does not seem to negatively affect the dental arch relationship at the age of 10 years in comparison to L-ABG.
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Affiliation(s)
| | - Lisa Bettelini
- Private Practice, Winkelstrasse 22, 1716 Plaffeien, Switzerland
| | - Andrzej Brudnicki
- Department of Paediatric Surgery (Head of the Department: Prof. Ewa Sawicka), Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland
| | - Martin Rachwalski
- Department of Maxillofacial and Plastic Surgery (Head of the Department: Prof. Arnaud Picard), National Reference Center for Cleft Lip and Palate, Hôpital Universitaire Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France
| | - Piotr S Fudalej
- Department of Orthodontics (Head of the Department: Doc. Milos Spidlen), Institute of Dentistry and Oral Sciences, Palacky University Olomouc, Palackeho 12, 771 00 Olomouc, Czech Republic; Department of Orthodontics and Dentofacial Orthopaedics (Head of the Department: Prof. Christos Katsaros), University of Bern, Freiburgstrasse 9, 3010 Bern, Switzerland.
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16
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Thierens LA, Lewyllie A, Temmerman L, De Roo NM, Verdonck A, Cadenas de Llano Perula M, Willems G, De Pauw GA. A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients. Clin Oral Investig 2018; 23:1777-1784. [PMID: 30171346 DOI: 10.1007/s00784-018-2601-0] [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] [Received: 03/06/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The objectives of this retrospective equivalence trial were to assess the dental arch relationship of 5- to 6-year-old patients with unilateral cleft lip and palate (UCLP) treated in two specialized cleft centers with a different surgical protocol using the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system, and to determine the correlation between these two scoring indices. MATERIALS AND METHODS The dental arch relationship of seventy-three 5- to 6-year-old patients with complete UCLP was evaluated on plaster casts using the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system. The sagittal occlusion, overbite, and overjet were also recorded. Inter- and intra-examiner agreement was determined using Intraclass Correlation Coefficients. RESULTS A good to very good inter- and intra-examiner agreement was found. No significant mean difference in outcome based on the 5-Year-Olds' Index, the modified Huddart/Bodenham scoring system, overjet, or overbite was detected. For mean difference in sagittal occlusion, the hypothesis that both centers are clinically equivalent was confirmed. A strong negative correlation (rs = - 0.832) between the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system was found. CONCLUSIONS The dental arch relationship of 5- to 6-year-old unilateral cleft patients treated in two Belgian cleft centers is clinically equivalent based on sagittal occlusion, despite substantial differences in their treatment protocol. Clinical equivalence for other parameters was not confirmed. There is a strong correlation between the 5-Year-Olds' Index and the modified Huddart/Bodenham scoring system. CLINICAL RELEVANCE A well-implemented treatment protocol for cleft patients is of the utmost importance, but case load and skill of the surgeon are also important factors for the quality of the results.
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Affiliation(s)
- Laurent Am Thierens
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium. .,Centre for Congenital Facial Anomalies, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Arianne Lewyllie
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Liesbeth Temmerman
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Noëmi Mc De Roo
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - An Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas de Llano Perula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Am De Pauw
- Oral Health Sciences, Department of Orthodontics, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.,Centre for Congenital Facial Anomalies, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
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17
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Abstract
No agreement exists on the most appropriate timing of orthodontic treatment in patients with cleft lip and palate. The aim of this study is to investigate the effect of early orthodontic treatment on development of the dental arches and alveolar bone.A dental casts analysis was performed on 28 children with cleft lip and palate before orthodontic treatment (T0; mean age, 6.5 ± 1.7) and at the end of active treatment (T1; mean age, 9.2 ± 2.1 years). The considered variables were: intercanine and intermolar distances; dental arch relationships, evaluated according to the modified Huddart/Bodenham system.The study group was divided into 2 samples according to the age at T0: Group A (age < 6 years) and Group B (age ≥ 6 years). A statistical comparison of the treatment effects between the 2 samples was performed.Patients in Group A exhibited a greater increase of intercanine distance (8 mm versus 2.7 mm; P<0.001), intermolar distance (7.2 mm versus 5 mm; P = 0.06), and Huddart/Bodenham score (7.1 versus 3; P < 0.05) when compared with patients in Group B.Early orthodontic treatment strongly improved the dental arch relationship, since subjects starting the therapy before the age of 6 had a better response in terms of anterior maxillary expansion.
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18
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Fowler P, Bellardie H, Shaw B, Eyres P, Semb G, Thompson J. Reliability of a Categorical Scale (GOSLON) and a Continuous Scale (10-cm Visual Analog Scale) for Assessing Dental Arch Relationships Using Conventional Plaster and 3D Digital Orthodontic Study Models of Children With Complete Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2018; 56:84-89. [DOI: 10.1177/1055665618770054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To assess reliability of scoring plaster models and their 3D digital copy of children with complete unilateral cleft lip and palate (CUCLP) using a continuous scale (10-cm visual analog scale [VAS]) and a categorical scale (GOSLON Yardstick). Design: Reliability observational study involving 3 trained GOSLON Yardstick assessors blinded to the origin of the models. Patients: Models from 35 New Zealand (NZ) and 35 Oslo CUCLP patients were standardized and randomly ordered before rating. Outcome Measures: Assessments were undertaken using the GOSLON and the VAS for both model formats. Twenty percent of sample were randomly selected and rescored at the first assessment, and whole sample was rescored 1 week later. Weighted κ was used to assess GOSLON reliability, while correlation was used for the VAS. Results: The VAS and GOSLON intra- and inter-rater agreement was similar for both model formats. Repeat measurements on the day have similar intra-rater reliability as repeat measurements at least a week part. There was no significant difference between the 2 model formats, and both the GOSLON and VAS found the NZ models were significantly worse than Oslo. Conclusions: A 10-cm VAS is a reliable method to assess dental arch relationships and appears to have good face validity when compared to GOSLON. The VAS allows for statistically robust rankings of the dental arch relationships, although more studies will be required to enable the VAS scores to have greater clinical meaning. The 3D digital models can be used for GOSLON and VAS rankings with a high degree of reliability.
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Affiliation(s)
- Peter Fowler
- Hospital Dental Service, Hillmorton Hospital, Christchurch, New Zealand
- Department of Paediatrics, Child and Youth Health, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand
| | - Haydn Bellardie
- Royal Manchester Children’s Hospital, Manchester, United Kingdom
| | - Bill Shaw
- School of Dentistry, University of Manchester, Manchester, United Kingdom
| | - Phil Eyres
- School of Dentistry, University of Manchester, Manchester, United Kingdom
| | - Gunvor Semb
- School of Dentistry, University of Manchester, Manchester, United Kingdom
- Oslo University Hospital, Oslo, Norway
| | - John Thompson
- Department of Paediatrics, Child and Youth Health, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand
- Department of Obstetrics and Gynaecology, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand
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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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20
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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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Yakob M, Hassan YR, Tse KL, Gu M, Yang Y. Comparing Modified Huddart-Bodenham Scoring System and GOSLON Yardstick to Assess Dental Arch Relationships in Unilateral Cleft Lip and Palate Patients. Cleft Palate Craniofac J 2018; 55:983-988. [PMID: 28092164 DOI: 10.1597/16-191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To test the reliability of the modified Huddart-Bodenham (MHB) numerical scoring system and its agreement with the GOSLON Yardstick categorization for assessing the dental arch relationships in unilateral cleft lip and palate (UCLP) cases. DESIGN A retrospective study. SETTING Faculty of Dentistry, The University of Hong Kong. PATIENTS Forty-one nonsyndromic UCLP consecutive patients attending the Joint Cleft Lip/Palate Clinic at Faculty of Dentistry in the University of Hong Kong were selected. INTERVENTIONS Study models at 8 to 10 years old (T1) and 10 to 12 years old (T2) were obtained from each patient. MAIN OUTCOME MEASURES Models were rated with the MHB scoring system and GOSLON Yardstick index. The intra- and interexaminer reliabilities as well as correlation of both scoring systems were evaluated. Furthermore, to investigate the outcome measurements consistency, the MHB scoring system and GOSLON Yardstick were independently used to compare the dental arch relationships from T1 to T2, with the samples split into intervention and nonintervention groups. RESULTS The MHB scoring system presented good intra- and interexaminer agreement, which were comparable to those of the GOSLON Yardstick. The correlation between the MHB scoring system and GOSLON Yardstick scores was good. Both scoring systems showed similar results when assessing the change in the dental arch relationships from T1 to T2. CONCLUSIONS The MHB scoring system can be used as an alternative method to the commonly used GOSLON Yardstick for assessing dental deformities in UCLP patients. Both scoring systems showed similar results in assessing the improvement in dental arch relationships.
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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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Montes ABM, de Oliveira TM, Gavião MBD, de Souza Barbosa T. Occlusal, chewing, and tasting characteristics associated with orofacial dysfunctions in children with unilateral cleft lip and palate: a case-control study. Clin Oral Investig 2017; 22:941-950. [PMID: 28761982 DOI: 10.1007/s00784-017-2173-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/28/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study is to assess the associations between orofacial dysfunctions with malocclusion, masticatory performance, and taste in children with and without unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS A patient-based, matched, case-control study was conducted involving 108 8- to 10-year-old children divided in UCLP and control groups. Orofacial dysfunctions were evaluated using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need was evaluated using the Goslon Yardstick Index (GYI) and the Index of Orthodontic Treatment Need (IOTN) of patients and controls, respectively. Masticatory performance was assessed using a chewable test material to determine median particle size (X 50) and distribution of particles in different sieves (b value). Taste perception was evaluated using four solutions (sweet, salty, bitter, or acid) in three different concentrations. RESULTS More than half of the patients needed orthodontic surgery. UCLP group presented higher median particle size and needed more chewing cycles to comminute the artificial test into particles smaller than the median than those of controls. UCLP group had less perception of salty flavor than controls. There was a positive correlation between b value and NOT-S examination score for patients. In regression analysis, a significant interrelationship was observed between NOT-S examination score and b value. CONCLUSIONS In the UCLP patients, masticatory performance was compromised probably as a result of facial asymmetry and speech disturbance; whereas, taste was less perceived only for salty flavor. CLINICAL RELEVANCE These findings provide preliminary evidence that mastication and taste are altered in children with UCLP, so these factors must be followed up to ensure oral and general health in growing individuals.
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Affiliation(s)
- Ana Bheatriz Marangoni Montes
- Department of Pediatric Dentistry, Pedodontic Division, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, SP, 13414-903, Brazil
| | - Thais Marchini de Oliveira
- Department of Pediatric Dentistry, Bauru School of Dentistry, University of São Paulo, Avenida Otávio Pinheiro Brizola 9-75, Bauru, SP, 17043-012, Brazil
| | - Maria Beatriz Duarte Gavião
- Department of Pediatric Dentistry, Pedodontic Division, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, SP, 13414-903, Brazil
| | - Taís de Souza Barbosa
- Department of Pediatric Dentistry, Pedodontic Division, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, SP, 13414-903, Brazil.
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Hosseini HR, Kaklamanos EG, Athanasiou AE. Treatment outcomes of pre-surgical infant orthopedics in patients with non-syndromic cleft lip and/or palate: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2017; 12:e0181768. [PMID: 28742129 PMCID: PMC5524403 DOI: 10.1371/journal.pone.0181768] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/05/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family environment. Although the use of pre-surgical infant orthopedics (PSIO) was introduced as a means to improve management and treatment outcomes, there still remains a controversy. OBJECTIVE To investigate the effectiveness of PSIO in patients with non-syndromic CL/P and evaluate the quality of the available evidence. SEARCH METHODS Search without restrictions, together with hand searching, until May 2016. SELECTION CRITERIA Randomized clinical trials investigating the effects of pre-surgical infant orthopedic appliances. DATA COLLECTION AND ANALYSIS Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS Finally 20 papers (3 unique trials) were identified, involving a total of 118 patients with unilateral complete CL/P and 16 with cleft of the soft and at least two thirds of the hard palate. Eight publications were considered as being of low, four of unclear and eight of high risk of bias. In general, the investigated appliances did not present significant effects when compared to each other or to no treatment in terms of feeding and general body growth, facial esthetics, cephalometric variables, maxillary dentoalveolar variables and dental arch relationships, speech and language evaluation, caregiver-reported outcomes, economic evaluation, as well as, adverse effects and problems. Overall, the quality of the available evidence was considered low. CONCLUSIONS The aforementioned findings could provide initial guidance in the clinical setting. However, given the multitude of parameters, which may have affected the results, good practice would suggest further research, in order to reach more robust relevant recommendations for management decisions in individual cases.
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Affiliation(s)
- Hamid Reza Hosseini
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Eleftherios G. Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Athanasios E. Athanasiou
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Reddy RR, Gosla Reddy S, Vaidhyanathan A, Bergé SJ, Kuijpers-Jagtman AM. Maxillofacial growth and speech outcome after one-stage or two-stage palatoplasty in unilateral cleft lip and palate. A systematic review. J Craniomaxillofac Surg 2017; 45:995-1003. [DOI: 10.1016/j.jcms.2017.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/17/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022] Open
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Buj-Acosta C, Paredes-Gallardo V, Montiel-Company JM, Albaladejo A, Bellot-Arcís C. Predictive validity of the GOSLON Yardstick index in patients with unilateral cleft lip and palate: A systematic review. PLoS One 2017; 12:e0178497. [PMID: 28570588 PMCID: PMC5453533 DOI: 10.1371/journal.pone.0178497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 05/14/2017] [Indexed: 12/02/2022] Open
Abstract
Among the various indices developed for measuring the results of treatment in patients born with unilateral cleft lip and palate (UCLP), the GOSLON Yardstick index is the most widely used to assess the efficacy of treatment and treatment outcomes, which in UCLP cases are closely linked to jaw growth. The aim of this study was to conduct a systematic review to validate the predictability of growth using the GOSLON Yardstick in patients born with UCLP. A systematic literature review was conducted in four Internet databases: Medline, Cochrane Library, Scopus and Embase, complemented by a manual search and a further search in the databases of the leading journals that focus on this topic. An electronic search was also conducted among grey literature. The search identified a total of 131 articles. Duplicated articles were excluded and after reading titles and abstracts, any articles not related to the research objective were excluded, leaving a total of 21 texts. After reading the complete text, only three articles fulfilled the inclusion criteria. The results showed a predictive validity of between 42.2% and 64.7%, which points to a lack of evidence in the literature for the predictive validity of the GOSLON Yardstick index used in children born with UCLP.
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Affiliation(s)
- Cindy Buj-Acosta
- Orthodontics Teaching Unit, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Vanessa Paredes-Gallardo
- Orthodontics Teaching Unit, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
- * E-mail:
| | - José María Montiel-Company
- Preventive Teaching Unit, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Alberto Albaladejo
- Orthodontics Department, Faculty of Dentistry, University of Salamanca, Salamanca, Spain
| | - Carlos Bellot-Arcís
- Orthodontics Teaching Unit, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Karsten A, Marcusson A, Hurmerinta K, Heliövaara A, Küseler A, Skaare P, Bellardie H, Rønning E, Shaw W, Mølsted K, Sæle P, Brinck E, Rizell S, Najal Chalier M, Eyres P, Semb G. Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index. J Plast Surg Hand Surg 2017; 51:58-63. [DOI: 10.1080/2000656x.2016.1265529] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Agneta Karsten
- Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, University Hospital, Linköping, Sweden
| | - Kirsti Hurmerinta
- Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Arja Heliövaara
- Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Pål Skaare
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Haydn Bellardie
- Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens’ Hospital, Manchester, UK
| | - Elisabeth Rønning
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - William Shaw
- Dental School, University of Manchester, Manchester, UK
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Paul Sæle
- Oral Health Center of Expertise/Western Norway, Bergen, Norway
| | - Eli Brinck
- Oral Health Center of Expertise/Western Norway, Bergen, Norway
| | - Sara Rizell
- Department of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Midia Najal Chalier
- Department of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Philip Eyres
- Dental School, University of Manchester, Manchester, UK
| | - Gunvor Semb
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Dental School, University of Manchester, Manchester, UK
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Hassan YR, Tse KL, Khambay B, Wong RWK, Gu M, Yang Y. Dental Arch Relationships and Reverse Headgear Effects in Southern Chinese Patients with Unilateral Cleft Lip and Palate: A Retrospective Study. Cleft Palate Craniofac J 2017; 55:925-934. [PMID: 28094563 DOI: 10.1597/15-155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the severity of the dental arch relationships and the treatment outcomes of reverse headgear (RHG) in southern Chinese patients with unilateral cleft lip and palate (UCLP). DESIGN A retrospective study. SETTING Faculty of Dentistry, The University of Hong Kong. PATIENTS Thirty-eight UCLP patients with complete records. Among them, 14 were later treated with RHG (RHG group) and 24 were under review (non-RHG group) before definitive orthodontic or in conjunction with orthognathic surgery. INTERVENTIONS Study models at T1 (aged 9.4 ± 0.4 years old), prebone grafting and before any orthodontic treatment started; T2 (aged 11.3 ± 0.6 years old), after bone grafting, and RHG treatment (RHG group) or under review (non-RHG group); and T3 (aged 15.3 ± 3.2 years old), pretreatment of definitive orthodontic or in conjunction with orthognathic surgery. MAIN OUTCOME MEASURES With satisfactory intra- and interexaminer agreement proven by the kappa value, the dental arch relationships of the study models at T1, T2, and T3 were assessed by a solo calibrated examiner using the GOSLON Yardstick. RESULTS The median GOSLON score for southern Chinese patients with UCLP at T1 was 4.0. Sixty percent of the patients were categorized as "poor" at T1. RHG significantly improved dental arch relationships from T1 to T2, and the improvement was maintained until T3 assessed by the GOSLON Yardstick. CONCLUSIONS The dental arch relationships in southern Chinese UCLP patients at 8 to 10 years old are unfavorable. RHG treatment shows positive effects in improving the dental arch relationships in UCLP patients, as assessed by the GOSLON Yardstick.
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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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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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Almuhizi Y, Leser A, Pegelow M. Correlation between the modified Huddart and Bodenham index and the GOSLON yardstick for assessing occlusal characteristics at 5 and 10 years of age in individuals born with unilateral cleft lip and palate. Eur J Orthod 2016; 38:359-65. [DOI: 10.1093/ejo/cjw046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Jamilian A, Lucchese A, Darnahal A, Kamali Z, Perillo L. Cleft sidedness and congenitally missing teeth in patients with cleft lip and palate patients. Prog Orthod 2016; 17:14. [PMID: 27135068 PMCID: PMC4864872 DOI: 10.1186/s40510-016-0127-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 03/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender. Methods The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial tests were used for assessment of the data. Results and conclusions One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients (P < 0.001). This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area.
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Affiliation(s)
- Abdolreza Jamilian
- Department of Orthodontics, Orthognathic Surgery, Tehran Dental Branch, Craniomaxillofacial Research Center, Islamic Azad University, No 2713, Vali Asr St, Tehran, 1966843133, Iran.
| | - Alessandra Lucchese
- Department of Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
| | - Alireza Darnahal
- Department of Orthodontics, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Zinat Kamali
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Letizia Perillo
- Orthodontic Unit and Chair of Postgraduate Orthodontic Program, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
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Martin CB, Ma X, McIntyre GT, Wang W, Lin P, Chalmers EV, Mossey PA. The validity and reliability of an automated method of scoring dental arch relationships in unilateral cleft lip and palate using the modified Huddart–Bodenham scoring system. Eur J Orthod 2016; 38:353-8. [DOI: 10.1093/ejo/cjw031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Jones T, Leary S, Atack N, Ireland T, Sandy J. Which index should be used to measure primary surgical outcome for unilateral cleft lip and palate patients? Eur J Orthod 2016; 38:345-52. [PMID: 26988992 DOI: 10.1093/ejo/cjw013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the optimal dentoalveolar measure to assess unilateral cleft lip and palate (UCLP) patient plaster models. DESIGN The models of 34 patients with UCLP taken at 5, 10, and 15-20 years of age were scored by two examiners on two separate occasions using five indices: the 5 Year Olds' (5YO), GOSLON, Modified Huddart/Bodenham (MHB), EUROCRAN, and Overjet. Reliability, validity, and ease of use were recorded for each index/examiner. SETTING All models were scored in either Bristol Dental Hospital or Derriford Hospital, Plymouth, United Kingdom by senior orthodontic clinicians. RESULTS Highest overall reliability was seen with MHB (Kappa = 0.56-0.97). Predictive validity was similar for MHB, GOSLON, and 5YO with a 50-65 per cent prediction of final outcome from 5 and 10 years. EUROCRAN palatal index showed no clear predictive validity (Spearman's correlation = 0.20-0.21). Agreement to the gold standard 5YO score at the 5-year age group was high for MHB (Kappa = 0.83) and moderate for GOSLON (Kappa = 0.59). Agreement to the gold standard GOSLON score at 10 years was highest for 5YO (Kappa = 0.69), followed by Overjet (Kappa = 0.59) and MHB (Kappa = 0.46). Time to score 34 models per index (minutes): GOSLON (13.4) < Overjet (13.6) < 5YO (19.4) < EUROCRAN (24.8) < MHB (27.4). CONCLUSION As an outcome measure of UCLP models, only MHB and 5YO indices can be recommended for use at 5 years of age and GOSLON at 10 years of age.
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Affiliation(s)
- Timothy Jones
- School of Oral and Dental Sciences, Bristol Dental Hospital, UK and Musgrove Park Hospital, Taunton, UK
| | - Sam Leary
- School of Oral and Dental Sciences, Bristol Dental Hospital, UK and
| | - Nikki Atack
- School of Oral and Dental Sciences, Bristol Dental Hospital, UK and Musgrove Park Hospital, Taunton, UK
| | - Tony Ireland
- School of Oral and Dental Sciences, Bristol Dental Hospital, UK and
| | - Jonathan Sandy
- School of Oral and Dental Sciences, Bristol Dental Hospital, UK and
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Chalmers EV, McIntyre GT, Wang W, Gillgrass T, Martin CB, Mossey PA. Intraoral 3D Scanning or Dental Impressions for the Assessment of Dental Arch Relationships in Cleft Care: Which is Superior? Cleft Palate Craniofac J 2015; 53:568-77. [PMID: 26623548 DOI: 10.1597/15-036] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This study was undertaken to evaluate intraoral 3D scans for assessing dental arch relationships and obtain patient/parent perceptions of impressions and intraoral 3D scanning. MATERIALS & METHODS Forty-three subjects with nonsyndromic unilateral cleft lip and palate (UCLP) had impressions taken for plaster models. These and the teeth were scanned using the R700 Orthodontic Study Model Scanner and Trios® Digital Impressions Scanner (3Shape A/S, Copenhagen, Denmark) to create indirect and direct digital models. All model formats were scored by three observers on two occasions using the GOSLON and modified Huddart Bodenham (MHB) indices. Participants and parents scored their perceptions of impressions and scanning from 1 (very good) to 5 (very bad). Intra- and interexaminer reliability were tested using GOSLON and MHB data (Cronbach's Alpha >0.9). Bland and Altman plots were created for MHB data, with each model medium (one-sample t tests, P < .05) and questionnaire data (Wilcoxon signed ranks P < .05) tested. RESULTS Intra- and interexaminer reliability (>0.9) were good for all formats with the direct digital models having the lowest interexaminer differences. Participants had higher ratings for scanning comfort (84.8%) than impressions (44.2%) (P < .05) and for scanning time (56.6%) than impressions (51.2%) (P > .05). None disliked scanning, but 16.3% disliked impressions. Data for parents and children positively correlated (P < .05). CONCLUSIONS Reliability of scoring dental arch relationships using intraoral 3D scans was superior to indirect digital and to plaster models; Subjects with UCLP preferred intra-oral 3D scanning to dental impressions, mirrored by parents/carers; This study supports the replacement of conventional impressions with intra-oral 3D scans in longitudinal evaluations of the outcomes of cleft care.
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Rating dental arch relationships and palatal morphology with the EUROCRAN index on three different formats of dental casts in children with unilateral cleft lip and palate. Clin Oral Investig 2015; 20:943-50. [PMID: 26462656 PMCID: PMC4873539 DOI: 10.1007/s00784-015-1595-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 09/09/2015] [Indexed: 11/30/2022]
Abstract
Background The EUROCRAN index has been used in inter-center studies to assess dental arch relationship (DAR) and palatal morphology (PM) in children with unilateral cleft lip and palate (UCLP). For this type of inter-center research, a scoring method that could be performed over the internet would be the most effective. Therefore, the aim of this study was to investigate the reliability of application of the EUROCRAN index on 3D digital models or photographs of plaster models instead of using plaster models. Methods The EUROCRAN reference models were presented in three formats: plaster models, 2D photographs of plaster models, and 3D digital models. Plaster models of children with UCLP (n = 45) were rated. Of each case, all three formats were rated by six calibrated observers in random order. The strength of agreement of the ratings was assessed with kappa statistics. Concordance among observers was evaluated with the intra-class correlation coefficient (ICC). Results The ICC showed a good inter-observer agreement for the DAR and poor inter-observer agreement for the PM. Intra-observer agreement for the DAR was moderate to very good, yet for the PM poor to moderate. Comparison between the three formats per observer for the DAR was good or very good and for the PM moderate to poor. Conclusions The overall results show that the EUROCRAN index is an acceptable and reliable scoring method for the DAR on plaster models, 2D photographs of plaster models, and 3D digital models. However, due to the small range of deviations in palatal morphology between the cases in our study, the PM component of the index was difficult to assess. Clinical relevance In clinical audits and inter-center studies, plaster models can be substituted by 2D photographs of plaster casts or 3D digital models when grading treatment outcome with the EUROCRAN index.
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Zhu S, Yang Y, Gu M, Khambay B. A Comparison of Three Viewing Media for Assessing Dental Arch Relationships in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2015; 53:578-83. [PMID: 26406557 DOI: 10.1597/15-144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To determine the repeatability and reproducibility of using three different viewing media to assess the outcomes of the dental arch relationships of patients with unilateral cleft lip and palate (UCLP) using the GOSLON Yardstick. DESIGN The GOSLON Yardstick was used to rate the dental arch relationships of 29 patients with UCLP. Three experienced calibrated orthodontists rated the plaster study models, digital study models, and stereoscopic projected three-dimensional (3D) study models separately. There was a minimum of a 1-week interval between each rating session. All three rating sessions were repeated 1 month later. A linear weighted kappa statistic was performed to assess intra-rater repeatability and inter-rater reproducibility, as well as the comparison between different viewing media using Kendall's Coefficient of Concordance (Kendall's W) statistic. RESULTS Intra-rater repeatability was very good for all three viewing media (kappa = 0.83-0.92). Inter-rater reproducibility was good to very good across the three viewing media (kappa = 0.63-0.88). Agreements between plaster study models and digital study models or stereoscopic projected 3D study models were good to very good (kappa = 0.78-0.97 and kappa = 0.72-0.97, respectively), and a Kendall's W ranging from 0.86 to 0.92 (P < .001). CONCLUSIONS Stereoscopic projected 3D is an alternative method to assess the outcomes of dental arch relationships in patients with cleft lip and palate using the GOSLON Yardstick. It could also be used for viewing patient records, as it recovers the full 3D information captured at the time of the clinical examination.
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Noverraz RLM, Disse MA, Ongkosuwito EM, Kuijpers-Jagtman AM, Prahl C. Transverse dental arch relationship at 9 and 12 years in children with unilateral cleft lip and palate treated with infant orthopedics: a randomized clinical trial (DUTCHCLEFT). Clin Oral Investig 2015; 19:2255-65. [PMID: 25855466 PMCID: PMC4656704 DOI: 10.1007/s00784-015-1451-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 03/11/2015] [Indexed: 11/30/2022]
Abstract
Objective A long-term evaluation to assess the transverse dental arch relationships at 9 and 12 years of age in unilateral cleft lip and palate treated with or without infant orthopedics (IO). The hypothesis is that IO has no effect on the transverse dental arch relationship. Material and methods A prospective two-arm randomized controlled trial (DUTCHCLEFT) in three academic cleft palate centers (Amsterdam, Nijmegen and Rotterdam, the Netherlands). Fifty-four children with complete unilateral cleft lip and palate and no other malformations were enrolled in this evaluation. One group wore passive maxillary plates (IO+) during the first year of life, and the other group did not (IO−). Until the age of 1.5, all other interventions were the same. Hard palate was closed simultaneously with bone grafting according to protocol of all teams. Orthodontic treatment was performed when indicated. The transverse dental arch relationship was assessed on dental casts using the modified Huddart/Bodenham score to measure the maxillary arch constriction at 9 and 12 years of age. Results No significant differences were found between the IO+ and IO− groups. Differences between the centers increased from 9 to 12 years of age. Conclusions Transverse dental arch relationships at 9 and 12 years of age do not differ between children with UCLP treated with or without IO. Clinical relevance There is no orthodontic need to perform IO as applied in this study in children with UCLP.
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Affiliation(s)
- R L M Noverraz
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - M A Disse
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - E M Ongkosuwito
- Department of Orthodontics and Craniofacal Biology and Cleft Palate Craniofacial Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A M Kuijpers-Jagtman
- Department of Orthodontics and Craniofacal Biology and Cleft Palate Craniofacial Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - C Prahl
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Jamilian A, Jamilian M, Darnahal A, Hamedi R, Mollaei M, Toopchi S. Hypodontia and supernumerary and impacted teeth in children with various types of clefts. Am J Orthod Dentofacial Orthop 2015; 147:221-5. [DOI: 10.1016/j.ajodo.2014.10.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 11/24/2022]
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Antonarakis GS, Adibfar A, Tompson BD, Daskalogiannakis J, Fisher DM. Presurgical cleft lip anthropometrics and dental arch relationships in patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 2014; 52:269-76. [PMID: 24805871 DOI: 10.1597/13-272] [Citation(s) in RCA: 12] [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 investigate associations between anthropometric lip measurements and dental arch relationships in patients with complete unilateral cleft lip and palate (CUCLP). DESIGN Retrospective cross-sectional study. PATIENTS Children with CUCLP. METHODS Anthropometric lip measurements, made immediately prior to lip repair, were available for each patient. The dental arch relationships were evaluated on dental study casts (8.6 ± 0.9 years) taken prior to any orthodontic treatment and prior to alveolar bone graft, using the modified Huddart and Bodenham (MHB) scoring system. The presence of associations between anthropometric lip measurements and dental arch relationships was determined using linear regression analysis. RESULTS In the 63 patients included in the study, the cleft lateral lip element was deficient in height in 87% and in transverse width in 86% of patients. Patients with more deficient cleft-side lateral lip height were more likely to present with more negative MHB scores (r = .443; P < .001). Conversely, patients with more deficient cleft-side lateral lip transverse width more often presented with more positive MHB scores (r = .281; P = .025). CONCLUSIONS In patients with CUCLP, there is a wide variability in the degree of deficiency of the cleft-side lateral lip element, both in the vertical and in the transverse dimension. The extent of this deficiency may, in part, predict the resulting dental arch relationships.
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Jones T, Al-Ghatam R, Atack N, Deacon S, Power R, Albery L, Ireland T, Sandy J. A review of outcome measures used in cleft care. J Orthod 2013; 41:128-40. [DOI: 10.1179/1465313313y.0000000086] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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