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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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Feitosa MCP, Garib D, de Cássia Moura Carvalho Lauris R, Herkrath APQ, Vettore MV. The impact of orthognathic surgery on quality of life in individuals with oral clefts. Eur J Orthod 2021; 44:170-177. [PMID: 34173641 DOI: 10.1093/ejo/cjab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. MATERIALS AND METHODS A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. RESULTS OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (β = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (β = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (β = 0.02). LIMITATIONS The short follow-up period of 6 months after orthognathic surgery. CONCLUSIONS/IMPLICATIONS This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.
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Affiliation(s)
- Mariana Chaves Petri Feitosa
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | - Daniela Garib
- Dental Division, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.,Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | | | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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Sakamoto T, Ishii T, Sueishi K, Uchiyama T. Interdental Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patient with Wide Alveolar Cleft. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:201-209. [PMID: 32801263 DOI: 10.2209/tdcpublication.2019-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Alveolar bone grafting is routinely performed in repair of alveolar clefts. When the alveolar cleft is wider than 11 mm, however, the survival rate of the bone graft and prognosis are poor. Here, we describe successful orthodontic treatment using interdental distraction osteogenesis (IDO) with a tooth-tooth type distractor to reduce the width of the alveolar cleft in a patient with unilateral cleft lip and palate. The patient was a 12-year-old girl with unilateral cleft lip and palate, maxillary dentition midline deviation, congenitally missing maxillary lateral incisors, a palatally-displaced right upper first premolar, a wide alveolar cleft (20 mm), and mandibular prognathism due to maxillary hypoplasia. Treatment comprised a combination of orthodontic treatment and IDO. After treatment, appropriate occlusion, space closure in the maxillary arch, coincidence of the maxillary and facial midlines, and incorporation of the right maxillary first premolar into the arch were obtained. These results suggest that IDO is effective in treating cleft lip and palate patients with a wide alveolar cleft.
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Takahashi I, Sakamoto T, Ishii T, Sueishi K. Three-Dimensional Evaluation of Change in Maxillary Alveolar Arch after Expansion in Unilateral Cleft Lip and Palate Patients. THE BULLETIN OF TOKYO DENTAL COLLEGE 2020; 61:103-120. [PMID: 32522935 DOI: 10.2209/tdcpublication.2019-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Narrowing of the maxillary dental arch is a major cause of occlusal abnormalities in cleft lip and palate patients. Although the dental arch may be expanded in such cases, relapse will often occur during the subsequent retention period. In this study, the stability of expansion of the maxillary arch was investigated by examining 3-dimensional change in the maxillary arch during the treatment and post-retention periods. Three-dimensional measurements was performed on maxillary plaster models obtained from 8 unilateral cleft lip and palate patients (mean age, 12.5 years) who had undergone maxillary arch expansion using an edgewise appliance and quad helix (CLP group). The controls consisted of 8 unilateral cleft lip and alveolus patients (mean age, 12.9 years). Measurements were made during the pretreatment, post-treatment, and post-retention periods. In the CLP group, horizontal relapse was observed in the alveolar and dental arches between the second premolars, together with vertical relapse on the cleft side of the central incisor, lateral incisor, and canine. The sites where relapse occurred demonstrated decreased growth before orthodontic treatment. A correlation was observed between the extents of expansion and relapse. These findings suggest that excessive horizontal or vertical tooth movement in areas showing developmental failure should be avoided in order to increase stability after orthodontic treatment.
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Multivariate analysis of factors affecting dental arch relationships in Japanese unilateral cleft lip and palate patients at Hokkaido University Hospital. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.odw.2007.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Perillo L, Vitale M, d'Apuzzo F, Isola G, Nucera R, Matarese G. Interdisciplinary approach for a patient with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop 2018; 153:883-894. [PMID: 29853246 DOI: 10.1016/j.ajodo.2016.12.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 02/07/2023]
Abstract
The oral rehabilitation of patients with cleft lip and palate is a challenge. The aim of this case report was to underline the importance of a sequential interdisciplinary approach to correct functional problems and improve facial esthetics for a patient with unilateral cleft lip and palate. Few clinical reports have described this treatment in a teenager. The patient, a girl, age 12.6 years, had a complete right cleft lip and palate with a Class II molar tendency and a full Class II canine relationship on the right side, and a full Class II molar relationship with a canine Class I on the left side. Transposed, impacted, and anomalously shaped teeth and crowding added to the patient's problems. Treatment included maxillary expansion and maxillary and mandibular extractions. An interdisciplinary approach was necessary to achieve proper occlusion and better esthetics.
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Affiliation(s)
- Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Maddalena Vitale
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Gaetano Isola
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
| | - Riccardo Nucera
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giovanni Matarese
- Section of Orthodontics, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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Peterson P, Mars M, Gowans A, Larson O, Neovius E, Henningsson G, Andlin-Sobocki A, Pegelow M, Lemberger M, Raud-Westberg LM, Karsten ALA. Mean GOSLON Yardstick Scores After 3 Different Treatment Protocols—A Long-term Study of Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2018; 56:236-247. [DOI: 10.1177/1055665618774010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: (1) To evaluate dental arch relationships, with the Great Ormond Street, London and Oslo (GOSLON) Yardstick, of participants with Unilateral cleft lip and palate (UCLP) and treated with 1-stage palatal closure with 3 different surgical protocols (2) to compare the mean GOSLON ratings with other CLP centers. Design: Retrospective study of medical charts and dental models. Setting: Karolinska University Hospital, Stockholm, Sweden. Participants: Eighty-seven patients with UCLP operated with 1-stage palatal repair. Thirty-five were operated with Veau-Wardill-Kilner (VWK) technique 1975 to 1986, 31 with minimal incision technique (MIT) from 1987 to 1997, and 21 according to MIT with muscle reconstruction (MITmr) 1998 to 2004. Interventions: Dental casts at ages 5 (n = 87), 7 to 8 (n = 27), 10 (n = 81), 16 (n = 61), and 19 (n = 35) years were rated by 10 assessors with the GOSLON Yardstick. Information of other interventions was retrieved from patients’ charts. Main outcome measures: Mean GOSLON ratings. Results: A total of 82% of the participants were rated as having excellent to satisfactory outcome. Weighted κ statistics for the 10 assessors was good for inter-rater agreement and good/very good for intra-rater agreement. Conclusions: The mean GOSLON score in the Stockholm overall material at age 10 was 2.67. The VWK technique resulted in a greater need of orthognathic surgery than the MIT ( P < .01). The MITmr did not produce better dental arch relationships than MIT at age 5 ( P < .05). The best dental arch relationships were found in the MIT group at 10 years, mean 2.58, which is not significantly different from other centers with excellent outcome except Gothenburg and Vienna.
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Affiliation(s)
- Petra Peterson
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Mars
- Department of Orthodontics, Great Ormond Street Hospital, London, United Kingdom
| | - Alan Gowans
- Department of Orthodontics, Leeds Dental Institute and Royal, College of Surgeons of Edinburgh, United Kingdom
| | - Ola Larson
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Neovius
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Gunilla Henningsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karoliniska Insitutet, Stockholm, Sweden
| | | | - Marie Pegelow
- Division of Orthodontics and Jaw Orthopedics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mathias Lemberger
- Division of Orthodontics and Jaw Orthopedics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Liisi M. Raud-Westberg
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta L-A Karsten
- Department of Reconstructive Plastic Surgery, Stockholm Cranofacial Team, Karolinska University Hospital, Stockholm, Sweden
- Division of Orthodontics, Department of Dental Medicine, Karolinska University Hospital, Stockholm, Sweden
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Peanchitlertkajorn S, Mercado A, Daskalogiannakis J, Hathaway R, Russell K, Semb G, Shaw W, Lamichane M, Fessler J, Long RE. An Intercenter Comparison of Dental Arch Relationships and Craniofacial Form Including a Center Using Nasoalveolar Molding. Cleft Palate Craniofac J 2018; 55:821-829. [DOI: 10.1597/16-018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare dental arch relationship and craniofacial morphology of patients with CUCLP in pre-adolescence from five cleft centers including a center using NAM. Design: Retrospective cohort study. Setting: Five cleft centers in North America. Patients: One hundred eighty-two subjects with repaired CUCLP from the five cleft centers participated in the craniofacial form study. One hundred forty-eight subjects from four of the five centers participated in the dental arch relationship study. Methods: Digital dental models were assessed using the GOSLON Yardstick. Eighteen cephalometric measurements were performed. Measurement means, by center, were compared. Analysis of variance and Tukey-Kramer analysis were used to compare GOSLON scores and cephalometric measurements. Results: The center that performed neither PSOT (including NAM) nor primary bone grafting exhibited the most favorable mean GOSLON score. The same center also showed the highest mean SNA, ANB, and ANS-N-Pg angles. However, the mean ANB and ANS-N-Pg angles were not significantly different from those of the center using NAM. No statistically significant differences were seen for mandibular prominence, vertical dimensions, or dental inclinations. The center with NAM also showed a significantly smaller nasoform angle than two of the four other centers. Conclusion: The centers that used NAM and other forms of PSOT did not have better dental arch relationships or craniofacial morphology compared with the centers that performed only primary lip repair. However, this study was not designed to investigate the cause-and-effect relationship between specific outcomes and particular features of those protocols.
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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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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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Mikoya T, Shibukawa T, Susami T, Sato Y, Tengan T, Katashima H, Oyama A, Matsuzawa Y, Ito Y, Funayama E. Dental Arch Relationship Outcomes in One- and Two-Stage Palatoplasty for Japanese Patients with Complete Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2015; 52:277-86. [DOI: 10.1597/13-285] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To compare dental arch relationship outcomes following one- and two-stage palatal repair. Design Nonrandomized, clinical trial with concurrent control. Setting Hokkaido University Hospital. Patients Sixty-eight consecutively treated Japanese patients with complete unilateral cleft lip and palate. Interventions Thirty-one of the 68 patients underwent two-stage palatoplasty with delayed hard palate closure, and 37 patients underwent one-stage pushback palatoplasty. Main Outcome Measures Dental casts were taken at 4.9 to 6.3 (mean: 5.2) years of age in the two-stage group and at 4.0 to 6.3 (mean: 5.1) years of age in the one-stage group, and dental arch relationships were assessed using the 5-Year-Olds’ Index (5-Y) by four raters and the Huddart/Bodenham Index (HB) by two raters. Results Intrarater and interrater reliabilities evaluated using weighted kappa statistics were good or better for the 5-Y and HB ratings. The mean 5-Y score was 2.94 in the two-stage group and 3.13 in the one-stage group ( P value was not significant). However, there was a significant difference in distributions between the groups ( P < .05). The HB scores of molars were significantly greater in the two-stage group than in the one-stage group ( P < .05). The rank correlation coefficients between the 5-Y and total HB score (ρ = −0.840, P < .01) and between the 5-Y and the score of the incisors in the HB (ρ = −0.814, P < .01) were significantly increased. Conclusions These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.
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Affiliation(s)
- Tadashi Mikoya
- Stomatognathic Function, Center for Advanced Oral Medicine, Hokkaido University Hospital
| | - Toyoko Shibukawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Hokkaido University
| | - Takafumi Susami
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshiaki Sato
- Department of Orthodontics, Graduate School of Dentistry, Hokkaido University
| | - Toshimoto Tengan
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hirotaka Katashima
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Akihiko Oyama
- Plastic and Reconstructive Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Yusuke Matsuzawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Hokkaido University
| | - Yumi Ito
- Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Hokkaido University
| | - Emi Funayama
- Plastic and Reconstructive Surgery, Hokkaido University Hospital, Sapporo, Japan
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Suzuki A, Sasaguri M, Hiura K, Yasunaga A, Mitsuyasu T, Kubota Y, Ninomiya T, Takenoshita Y. Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology? Cleft Palate Craniofac J 2014; 51:696-706. [DOI: 10.1597/12-103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.
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Affiliation(s)
- Akira Suzuki
- Department of Orthodontics, Kyushu University Hospital, Fukuoka, Japan
| | - Masaaki Sasaguri
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
| | | | - Atsushi Yasunaga
- Department of Orthodontics, Kyushu University Hospital, Fukuoka, Japan
| | - Takeshi Mitsuyasu
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
| | - Yasutaka Kubota
- Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Tomohiro Ninomiya
- Department of Oral and Maxillofacial Surgery, Kyushu University, Fukuoka, Japan
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Dogan S, Semb G, Erbay E, Alcan T, Uzel A, Kocadereli I, Shaw WC. Dental arch relationships in Turkish patients with complete unilateral cleft lip and palate born between 1976 and 1990: a comparison with eurocleft. Cleft Palate Craniofac J 2012; 51:70-5. [PMID: 22849640 DOI: 10.1597/11-304r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the dental arch relationships of Turkish patients with complete unilateral cleft lip and palate (UCLP) with the results reported for participants in the Eurocleft study. PATIENTS Study models of 109 patients with complete UCLP from five university clinics in Turkey were evaluated (clinic A = 25 patients, clinic B = 23 patients, clinic C = 20 patients, clinic D = 21 patients, and clinic E = 20 patients). The mean age of the patient cohort was nine years old (range = 8-11 years old), and the cohort was born between 1976 and 1990. METHODS The examiners rated the three-dimensional (3D) models using the GOSLON Yardstick. The scores were compared with those from the Eurocleft centers: E1(B), E2(E), E3(A), E4(F), E5(C), and E6(D). Intra- and interexaminer agreements were evaluated using weighted kappa statistics. RESULTS The mean GOSLON scores for the Turkish clinics were as follows: clinic A = 3.16, clinic B = 3.13, clinic C = 3.25, clinic D = 3.67, and clinic E = 3.70. Scores for three of the Turkish clinics (A, B, and C) were significantly worse than the scores for the three best Eurocleft centers, E1(B), E2(E), and E3(A) (P < .001, P < .001, and P < .05, respectively). Scores for two of the Turkish clinics (D and E) were similar to those for Eurocleft center E6(D) but worse than the scores for the other Eurocleft centers (P < .01, P < .001, respectively). CONCLUSIONS This was the first study in which three-dimensional models were used to derive scores to compare with those of the Eurocleft centers. According to the results of analysis of 109 3D models, 50.4 % of the patients in Turkey were classified as GOSLON score 4 and 5. This may have been attributable to poor surgical procedures, low-volume surgeons, and the decentralized treatment approach in Turkey between 1985 and 2000. Further research is needed to assess the situation in Turkey in more recent years.
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Love R, Walters M, Southall P, Singer S, Gillett D. Dental Arch Relationship Outcomes in Children with Complete Unilateral Cleft Lip and Palate Treated at Princess Margaret Hospital for Children, Perth, Western Australia. Cleft Palate Craniofac J 2012; 49:456-62. [DOI: 10.1597/10-111] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives To (1) audit dental arch relationships of all children born between 1982 and 1999 with complete unilateral cleft lip and palate (UCLP) treated at the Cleft Lip and Palate Unit, Princess Margaret Hospital for Children (PMH), Perth, Western Australia, (2) assess the distribution of GOSLON ratings from dental casts taken at 9 years, (3) compare the 9-year GOSLON ratings for “High” and “Low” caseload surgeons, and (4) compare the 9-year PMH GOSLON ratings with published ratings from other units. Design Retrospective audit of dental casts and medical charts. Patients Dental casts were retrieved for 71 children (47 boys and 24 girls) at 9 years of age. Main Outcome Measures GOSLON ratings. Results Sixty-eight percent of patients had an excellent to satisfactory dental arch relationship (GOSLON Yardstick ratings 1 to 3) at 9 years with a mean rating of 2.85. High caseload surgeons achieved statistically better mean GOSLON ratings than low caseload surgeons (2.72 and 3.33, respectively). Conclusions PMH Cleft Unit's dental arch relationship outcomes are comparable to published series of units using similar treatment protocols. High caseload surgeons achieved better dental arch relationships than low caseload surgeons.
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Affiliation(s)
- Robert Love
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Mark Walters
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Peter Southall
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Steve Singer
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - David Gillett
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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Uchiyama T, Yamashita Y, Susami T, Kochi S, Suzuki S, Takagi R, Tachimura T, Nakano Y, Shibui T, Michi KI, Nishio J, Hata Y. Primary Treatment for Cleft Lip and/or Cleft Palate in Children in Japan. Cleft Palate Craniofac J 2012; 49:291-8. [DOI: 10.1597/09-155] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate current trends in primary treatment for children with cleft lip and/or cleft palate in Japan. Design Nationwide, retrospective study under the direction of the Academic Survey Committee of the Japanese Cleft Palate Association based on analysis of data obtained via a booklet-style questionnaire completed by institutions providing primary treatment for cleft lip and/or palate patients. Participants, Patients Patients were 4349 children undergoing primary repair for cleft lip and/or palate at 107 participating institutions between 1996 and 2000. Main Outcome Measure(s) Cleft type, laterality; use of infant palatal plate; and timing and technique of primary repair for cleft lip and/or palate were evaluated by cleft surgeons at 107 participating institutions. Results Of a total of 2874 patients with cleft lip and palate or cleft palate only, infant palatal plates were used with 1087 (37.8%) and were not used with 1787 (62.2%). Primary unilateral lip repair was performed at the age of 2 to 6 months in more than 90% of patients. Bilateral cleft lip was treated by one-stage repair in 285 patients (44.5%) and by two-stage repair in 258 (40.2%). Primary one-stage palatal repair was performed in 2212 (76.9%) and two-stage palatal repair in 262 (9.1%) cleft palate patients. Information on treatment of the remaining 400 (14%) patients was unavailable. Conclusion This investigation clarified current trends in primary treatment for cleft lip and/or palate in Japan. The results suggest the need for an increase in regional core hospitals and greater variation in treatment options.
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Affiliation(s)
- Takeshi Uchiyama
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan
| | - Yukari Yamashita
- Department of Oral Rehabilitation, School of Dentistry, Showa University, Tokyo, Japan
| | - Takafumi Susami
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
| | - Shoko Kochi
- Clinics for Maxillo-Oral Disorders, Tohoku University Hospital Dental Center, Miyagi, Japan
| | - Shigehiko Suzuki
- Department of Plastic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery, Niigata University Graduate, School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Tachimura
- Osaka University Graduate School of Dentistry, Division of Functional Oral Neuroscience, Osaka, Japan
| | | | - Takeo Shibui
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan
| | | | - Juntaro Nishio
- Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yuiro Hata
- Division of Maxillofacial/Neck Reconstruction, Department of Head and Neck Reconstruction, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Kajii TS, Alam MK, Mikoya T, Oyama A, Koshikawa-Matsuno M, Sugawara-Kato Y, Sato Y, Iida J. Congenital and postnatal factors inducing malocclusions in Japanese unilateral cleft lip and palate patients-determination using logistic regression analysis. Cleft Palate Craniofac J 2012; 50:466-72. [PMID: 22409625 DOI: 10.1597/11-150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective : To assess the congenital and postnatal factors that affect degree of malocclusion in patients with unilateral cleft lip and palate using multivariate statistical analysis. Design : Retrospective study. Patients : All information on 135 subjects with unilateral cleft lip and palate was obtained from an oral examination and radiograph at the initial examination at an orthodontic clinic and from surgical records. Plaster models were taken before orthodontic treatment. The ages of the subjects ranged from 5 to 8 years with a mean age of 6.9 years. All primary surgeries for the patients were performed at a university hospital. Main Outcome Measures : The GOSLON Yardstick was used to assess the dental arch relationships (degree of malocclusion) in patients. Family history of Class III, degree of cleft, and congenitally missing upper lateral incisor on the cleft side were chosen as congenital factors inducing malocclusion. Presurgical orthopedic treatment, cheiloplasty, and palatoplasty were chosen as postnatal factors. Associations between various factors and dental arch relationships were assessed using logistic regression analysis. Results : According to adjusted odds ratios, family history of Class III is associated with a significantly worse dental arch relationship. Palatoplasty using push-back alone correlated to a dental arch relationship that was significantly worse than palatoplasty using push-back with a buccal flap. Conclusions : Multivariate analysis shows evidence that a positive family history of Class III and palatoplasty using push-back alone are associated with worse malocclusion of unilateral cleft lip and palate patients.
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Dogan S, Olmez S, Semb G. Comparative assessment of dental arch relationships using Goslon Yardstick in patients with unilateral complete cleft lip and palate using dental casts, two-dimensional photos, and three-dimensional images. Cleft Palate Craniofac J 2011; 49:347-51. [PMID: 21848360 DOI: 10.1597/10-269] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Comparison of the use of two-dimensional (2D) and three-dimensional (3D) images for rating dental arch relationships. MATERIALS AND METHODS The sample consists of pretreatment dental casts, 2D photographs, and 3D images of 70 patients with unilateral complete cleft lip and palate. Two experienced examiners used the Goslon Yardstick to rate dental arch relationships. The ratings were done three times for all groups. Weighted kappa statistics were used to evaluate intra- and interrater agreement and the agreement between the groups. RESULTS Intra- and interexaminer agreement were high for all groups (between 0.86 and 0.96), indicating very good reproducibility. The mean Goslon scores ranged between 2.84 and 2.90. CONCLUSION 2D and 3D imaging of dental casts provides a valid alternative for actual study models for rating dental arch relationships.
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Affiliation(s)
- Servet Dogan
- Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
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Russell K, Long RE, Hathaway R, Daskalogiannakis J, Mercado A, Cohen M, Semb G, Shaw W. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 5. General discussion and conclusions. Cleft Palate Craniofac J 2011; 48:265-70. [PMID: 21219225 DOI: 10.1597/09-187.1] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To summarize the Americleft study regarding treatment outcomes for patients with complete unilateral cleft lip and palate (CUCLP). SETTING Five cleft palate centers in North America. SUBJECTS One hundred sixty-nine subjects, between the ages of 6 years and 12 years, with repaired CUCLP who were consecutively treated at the five centers. METHODS Study consisted of model comparisons assessing maxillomandibular relationship using the GOSLON Yardstick (169 patients from all 5 centers), soft and hard tissue craniofacial morphologic comparisons using lateral cephalometric analyses (148 patients from four of the centers), and nasolabial esthetics assessments (125 patients from four of the centers). RESULTS Significant differences were found between the center with the best GOSLON scores and the remaining centers. These differences also corresponded to those found in the craniofacial morphologic cephalometric assessment. Sagittal maxillary prominence was found to be significantly better for the center with the best GOSLON scores, while no significant differences were seen among the centers for mandibular prominence, vertical dimensions, or dental inclinations. No differences were seen for nasolabial esthetics between the centers. CONCLUSIONS Challenges experienced while undertaking the inter-center retrospective study are reviewed. Aspects of treatment that could potentially make the outcome of treatment less optimal included primary alveolar bone grafting and extensive treatment protocols. Differences in the outcomes identified between the centers were restricted to the maxilla, and no differences were identified for mandibular prominence, vertical dimensions, or dental inclinations.
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Affiliation(s)
- Kathleen Russell
- Division of Orthodontics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.
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Hathaway R, Daskalogiannakis J, Mercado A, Russell K, Long RE, Cohen M, Semb G, Shaw W. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 2. Dental arch relationships. Cleft Palate Craniofac J 2011; 48:244-51. [PMID: 21219228 DOI: 10.1597/09-181.1] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare maxillomandibular relationships for individuals with nonsyndromic complete unilateral cleft lip and palate using the Goslon Yardstick for dental models. DESIGN Retrospective cohort study. SETTING Five cleft palate centers in North America. SUBJECTS A total of 169 subjects with repaired complete unilateral cleft lip and palate who were consecutively treated at the five centers. METHODS Ethics approval was obtained. A total of 169 dental models of patients between 6 and 12 years old with complete unilateral cleft lip and palate were assessed using the Goslon Yardstick. Weighted kappa statistics were used to assess intrarater and interrater reliabilities; whereas, analysis of variance and Tukey-Kramer analysis was used to compare the Goslon scores. Significance levels were set at p < .05. RESULTS Intrarater and interrater reliabilities were very good for model ratings. One center that incorporated primary alveolar bone grafting showed especially poor Goslon scores that were significantly poorer than the remaining centers. The surgery protocols used by the other four centers did not include primary alveolar bone grafting but involved a number of different lip and palate closure techniques. Using the Goslon Yardstick assumptions, the center with the best scores would be expected to require end-stage maxillary advancement orthognathic surgery in 20% of its patients; whereas, the center with the worst scores would be likely to require this surgery in 66% of its patients. CONCLUSIONS The Goslon Yardstick proved capable of discriminating among the centers' dental arch relationships. Possible explanations for the differences are discussed.
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Affiliation(s)
- Ronald Hathaway
- Craniofacial Center, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, Indiana, USA
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Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols. Clin Oral Investig 2010; 15:503-10. [PMID: 20473537 DOI: 10.1007/s00784-010-0420-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 04/21/2010] [Indexed: 10/19/2022]
Abstract
The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft at 9.2 months (SD, 2.0), were compared with a sample of 97 patients (mean age, 8.7 years; SD, 0.9), consecutively treated with a three-stage protocol including delayed hard palate closure in another center. The dental casts were assigned random numbers to blind their origin. Four raters graded dental arch relationship and palatal morphology using the EUROCRAN index. The strength of agreement of rating was assessed with kappa statistics. Independent t tests were run to compare the EUROCRAN scores between one-stage and three-stage samples, and Fisher's exact tests were performed to evaluate differences of distribution of the EUROCRAN grades. The intra- and inter-rater agreement was moderate to very good. Dental arch relationship in the one-stage sample was less favorable than in three-stage group (mean scores, 2.58 and 1.97 for one-stage and three-stage samples, respectively; p < 0.000). Palatal morphology in the one-stage sample was more favorable than in the three-stage group (mean scores, 1.79 and 1.96 for one-stage and three-stage samples, respectively; p = 0.047). The dental arch relationship following one-stage repair was less favorable than the outcome of three-stage repair. The palatal morphology following one-stage repair, however, was more favorable than the outcome of three-stage repair.
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de Ruiter A, van der Bilt A, Gert M, Ronald K. Orthodontie Treatment Results following Grafting Autologous Mandibular Bone to the Alveolar Cleft in Patients with a Complete Unilateral Cleft. Cleft Palate Craniofac J 2010; 47:35-42. [DOI: 10.1597/08-095.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To analyze orthodontic treatment results following mandibular symphysis bone grafting and postoperative orthodontic treatment. Design Randomized selection of 75 patients out of 308 with unilateral cleft of lip, alveolus, and palate, operated upon according to protocol between 1990 and 2008 in the Wilhelmina Children's Hospital, Utrecht, The Netherlands. Main Outcome Measure Goslon Yardstick rating changes of dental arch relationship. Significant agreement ( p < .001) was observed between the two assessments carried out with an interval of 3 months (Cohen's kappa = .963, p < .001). Results Following mandibular bone grafting and orthodontic treatment in 65.3% of the patients, the aim of treatment (Goslon Yardstick groups 1 and 2) had been achieved. The applied before/after Goslon allocations showed high improvement significance ( p < .001). Conclusions Postoperative orthodontic treatment in patients following grafting with mandibular symphysis bone showed excellent results.
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Affiliation(s)
- Ad de Ruiter
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands, and private practice, Harlingen, The Netherlands
| | - Andries van der Bilt
- Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Meijer Gert
- Department of Oral and Maxillofacial Surgery, University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Koole Ronald
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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Zreaqat M, Hassan R, Halim AS. Dentoalveolar relationships of Malay children with unilateral cleft lip and palate. Cleft Palate Craniofac J 2009; 46:326-30. [PMID: 19642750 DOI: 10.1597/07-210.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the treatment outcome based on dentoalveolar relationships among Malay children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). DESIGN Retrospective cohort study. SETTING AND SAMPLE POPULATION The Department of Orthodontics at the School of Dental Science and the Reconstructive Sciences Unit, School of Medical Science, Universiti Sains Malaysia. Dental study models of 82 UCLP Malay children aged 8 to 10 years were evaluated. All subjects had their cleft lip and palate repaired, but no alveolar bone graft or any orthodontic treatment was performed. OUTCOME MEASURE The outcome of dental arch relationships was assessed using the Goslon Yardstick Index: a dental measure with outcomes ranked on a scale ranging from 1 to 5. Agreement of rating was assessed with weighted kappa statistics; both intraexaminer and interexaminer agreements were high, indicating good reproducibility. RESULTS A total of 2.4% of the sample was in grade 1, 24.4% in grade 2, 35.4% in grade 3, 31.7% in grade 4, and 6.1% in grade 5. The mean Goslon index score was 3.15. CONCLUSION Dentoalveolar relationship outcomes of UCLP Malay children are intermediate according to the Goslon Yardstick. Interpretation of results should consider the ethnic differences in the craniofacial complex.
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Affiliation(s)
- Ma'en Zreaqat
- Orthodontic Unit, School of Dental Science, Universiti Sains Malaysia, Malaysia.
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Liao YF, Lin IF. Dental arch relationships after two-flap palatoplasty in Taiwanese patients with unilateral cleft lip and palate. Int J Oral Maxillofac Surg 2009; 38:1133-6. [DOI: 10.1016/j.ijom.2009.06.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 03/05/2009] [Accepted: 06/24/2009] [Indexed: 11/28/2022]
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Fudalej P, Hortis-Dzierzbicka M, Dudkiewicz Z, Semb G. Dental Arch Relationship in Children with Complete Unilateral Cleft Lip and Palate following Warsaw (One-Stage Repair) and Oslo Protocols. Cleft Palate Craniofac J 2009; 46:648-53. [DOI: 10.1597/09-010.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. Material: Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP consecutively treated with one-stage closure of the cleft at 9.2 months (range, 6.0 to 15.8 months; SD, 2.0) by the Warsaw Cleft Team at the Institute of Mother and Child, Poland, were compared with a sample drawn from a consecutive series of patients with UCLP treated by the Oslo Cleft Team and matched for age, gender, and soft tissue band. Methods: The study models were given random numbers to blind their origin. Four examiners rated the dental arch relationship using the GOSLON Yardstick. The strength of agreement of rating was assessed with weighted Kappa statistics. An independent t-test was carried out to compare the GOSLON scores between Warsaw and Oslo samples, and Fisher's exact tests were performed to evaluate the difference of distribution of the GOSLON scores. Results: The intrarater and interrater agreements were high (K ≥ .800). No difference in dental arch relationship between Warsaw and Oslo groups was found (mean GOSLON score = 2.68 and 2.65 for Warsaw and Oslo samples, respectively). The distribution of the GOSLON grades was similar in both groups. Conclusions: The dental arch relationship following one-stage repair (Warsaw protocol) was comparable with the outcome of the Oslo Cleft Team's protocol.
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Affiliation(s)
- Piotr Fudalej
- Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland
| | | | - Zofia Dudkiewicz
- Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland
| | - Gunvor Semb
- School of Dentistry, University of Manchester, United Kingdom; affiliated with the Oslo Cleft Team, Department of Plastic Surgery, University Hospital of Oslo, and Bredtvet Resource Center, Adjunct Professor at the Dental Faculty, University of Oslo, Norway
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Fudalej P, Katsaros C, Bongaarts C, Dudkiewicz Z, Kuijpers-Jagtman AM. Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols. J Oral Maxillofac Surg 2009; 67:1661-6. [PMID: 19615579 DOI: 10.1016/j.joms.2009.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 04/04/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE Facial esthetics play an important role in social interactions. However, children with a repaired complete unilateral cleft lip and palate usually show some disfigurement of the nasolabial area. To date, few studies have assessed the nasolabial appearance after different treatment protocols. The aim of the present study was to compare the nasolabial esthetics after 1- and 3-stage treatment protocols. MATERIALS AND METHODS Four components of the nasolabial appearance (nasal form, nasal deviation, mucocutaneous junction, and profile view) were assessed by 4 raters in 108 consecutively treated children who had undergone either 1-stage closure (Warsaw group, 41 boys and 19 girls, mean age 10.8 years, SD 2.0) or 3-stage (Nijmegen group, 30 boys and 18 girls, mean age 8.9 years, SD 0.7). A 5-grade esthetic index of Asher-McDade was used, in which grade 1 indicates the most esthetic and grade 5 the least esthetic outcome. RESULTS The nasal form was judged the least esthetic in both groups and graded 3.1 (SD 1.1) and 3.2 (SD 1.1). The nasal deviation, mucocutaneous junction, and profile view were scored from 2.1 (SD 0.8) to 2.3 (SD 1.0) in both groups. The treatment outcome after the Warsaw and Nijmegen protocols was comparable. Neither overall nor any of the 4 components of the nasolabial appearance showed intercenter differences (P > .1). CONCLUSIONS The nasolabial appearance after the Warsaw (1-stage) and Nijmegen (3-stage) protocols was comparable. The technique of lip repair (triangular flap in Warsaw and Millard rotation advancement in Nijmegen) gave comparable results for the esthetics of the nasolabial area.
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Affiliation(s)
- Piotr Fudalej
- Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
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Fudalej P, Hortis-Dzierzbicka M, Obloj B, Miller-Drabikowska D, Dudkiewicz Z, Romanowska A. Treatment Outcome after One-Stage Repair in Children with Complete Unilateral Cleft Lip and Palate Assessed with the Goslon Yardstick. Cleft Palate Craniofac J 2009; 46:374-80. [DOI: 10.1597/07-242.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. Materials and Methods: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and palate (UCLP) that was repaired with a one-stage simultaneous closure performed in the first year of life. All individuals were born between 1994 and 1995. The Goslon score (categories 1 to 5) was allocated. Intra- and interrater agreement was assessed with kappa statistics and Pearson correlation coefficient. Independent t tests were employed to detect difference between the score in the present and other published samples. Results: Mean Goslon score equaled 2.44; 57% of the patients were allocated Goslon category 1 or 2, 32% were rated Goslon 3, and 11% of the patients were assigned category 4 or 5. Intrarater agreement was between 0.75 and 0.77. Interrater agreement was 0.79. Conclusions: Dental arch relationship following one-stage repair was comparable with the results of the centers with the best outcome.
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Affiliation(s)
- Piotr Fudalej
- Department of Pediatric Surgery, Institute of Mother and Child in Warsaw, Poland
| | | | - Barbara Obloj
- Department of Pediatric Surgery, Institute of Mother and Child in Warsaw, Poland
| | | | - Zofia Dudkiewicz
- Department of Pediatric Surgery, Institute of Mother and Child in Warsaw, Poland
| | - Anna Romanowska
- Department of Pediatric Surgery, Institute of Mother and Child in Warsaw, Poland
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Li W, Lin J. Dental Arch Width Stability after Quadhelix and Edgewise Treatment in Complete Unilateral Cleft Lip and Palate. Angle Orthod 2007; 77:1067-72. [DOI: 10.2319/070506-272.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2006] [Accepted: 12/01/2006] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To evaluate the transverse stability of the dental arch in unilateral cleft lip and palate (UCLP) patients after orthodontic treatment with quadhelix and edgewise appliances.
Materials and Methods: Twenty repaired complete UCLP patients with posterior crossbites were chosen as the study subjects. All had ceased retention at least 15 months previously. Measurements were carried out directly on the pretreatment, posttreatment, and postretention study models using a three-dimensional dental cast analyzer. The interdental widths were measured for the canines, first premolars, second premolars, first molars, basal bone, and the alveolar arch. Two-way analysis of variance and Fisher's LSD was performed in comparing the difference between intervals.
Results: Lower inter-first-premolar width and upper arch widths of each region increased significantly (P < .05) after orthodontic treatment. The expansion was greater in the anterior than the posterior region in the upper arch, and the greatest increase was in the upper first premolar region. The upper arch width decreased after retention, with the decrease of the arch width in the upper canine (1.3 ± 0.8 mm) and first premolar (1.5 ± 0.8 mm) regions being statistically significant. The increased upper arch width in each region and the lower inter-first-premolar width maintained significant expansion after retention.
Conclusions: The widths of the dental arch increased significantly after expansion with a quadhelix followed by preadjusted edgewise treatment. Relapse occurred, especially in the upper canine and first premolar region, but most of the treatment effect on the upper arch remained after retention.
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Affiliation(s)
- Weiran Li
- a Clinical Professor, Orthodontic Department, School of Stomatology, Peking University, PR China
| | - Jiuxiang Lin
- b Professor, Orthodontic Department, School of Stomatology, Peking University, PR China
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2006; 14:289-91. [PMID: 16832188 DOI: 10.1097/01.moo.0000233602.37541.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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