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Ocak I, Akarsu-Guven B, Karakaya J, Ozgur F, Aksu M. Effects of nasoalveolar molding on maxillary arch dimensions and malocclusion characteristics in primary dentition patients with cleft lip and palate. Int J Paediatr Dent 2024; 34:94-101. [PMID: 37351851 DOI: 10.1111/ipd.13102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Nasoalveolar molding (NAM) is a presurgical orthopedic technique used in the management of cleft lip and palate deformities. Despite the widespread use of NAM therapy, there is a need for further investigation to assess its specific effects on arch dimensions and malocclusion characteristics. AIM To evaluate the effects of NAM therapy on maxillary arch dimensions and malocclusion characteristics in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). DESIGN Patients in primary dentition were referred to the Institutional Department of Orthodontics. The NAM group consisted of 21 patients with UCLP (mean age 4.7 ± 0.7 years) and 12 patients with BCLP (mean age 4.8 ± 0.7 years). Sixteen patients with UCLP (mean age 4.9 ± 0.9 years) and five patients with BCLP (mean age 5.4 ± 1.1 years) were included in the non-NAM group. The plaster models of all patients were digitized. Dental arch dimensions and malocclusion characteristics were analyzed via digital software. One-way ANOVA with Bonferroni correction was used for statistical analysis. RESULTS Intercanine and intermolar widths showed statistically significant differences according to the cleft type (p < .01). There was no statistically significant effect of NAM therapy on maxillary arch parameters and malocclusion characteristics (p > .05). The prevalence of anterior crossbite was 12.1% in the NAM group and 23.8% in the non-NAM group. CONCLUSION NAM therapy did not affect the maxillary arch dimensions and malocclusion characteristics in patients with UCLP and BCLP. The cleft type was the main factor, leading to a significant difference in maxillary widths.
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Affiliation(s)
- Irmak Ocak
- Department of Orthodontics, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - Bengisu Akarsu-Guven
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Figen Ozgur
- Department of Plastic Reconstructive and Aesthetic Surgery, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University Faculty of Medicine, Ankara, Turkey
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2
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Mossey PA, Lai J, Meazzini MC, Breugem C, Mark H, Mink van der Molen AB, Persson M, Davies G, Ozawa TO. Core outcomes for orofacial clefts: reconciling traditional and ICHOM minimum datasets. Eur J Orthod 2023; 45:671-679. [PMID: 37279564 PMCID: PMC10687512 DOI: 10.1093/ejo/cjad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE/DESIGN/SETTING This retrospective study sought voluntary participation from leading cleft centres from Europe and Brazil regarding core outcome measures. The results of this study would inform the debate on core outcome consensus pertaining to the European Reference Network for rare diseases (ERN CRANIO) and achieve a core outcome set for cleft care providers worldwide. INTERVENTION/METHOD Five orofacial cleft (OFC) disciplines were identified, within which all of the International Consortium of Health Outcomes Measurement (ICHOM) outcomes fall. One questionnaire was designed for each discipline and comprised 1. the relevant ICHOM's outcomes within that discipline, and 2. a series of questions targeted to clinicians. What core outcomes are currently measured and when, did these align with the ICHOM minimum, if not how did they differ, and would they recommend modified or additional outcomes?. RESULTS For some disciplines participants agreed with the ICHOM minimums but urged for earlier and more frequent intervention. Some clinicians felt that some of the ICHOM standards were compatible but that different ages were preferred and for others the ICHOM standards were acceptable but developmental stages should be preferred to absolute time points. CONCLUSION/IMPLICATIONS Core outcomes for OFC were supported in principle but there are differences between the ICHOM recommendations and the 2002 WHO global consensus. The latter are established in many centres with historical archives of OFC outcome data, and it was concluded that with some modifications ICHOM could be moulded into useful core outcomes data for inter-centre comparisons worldwide.
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Affiliation(s)
- Peter A Mossey
- Orthodontic Department, School of Dentistry, University of Dundee, Scotland, UK
| | - Jason Lai
- Orthodontic Department, School of Dentistry, University of Dundee, Scotland, UK
| | | | - Corstiaan Breugem
- Department of Plastic Reconstructive and Hand Surgery, Emma Children’s Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans Mark
- Department of Plastic Surgery, Sahlgrenska University Hospital and Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Martin Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Gareth Davies
- Stichting European Cleft Organisation, Rijswijk, The Netherlands
| | - Terumi Okada Ozawa
- Department of Orthodontics, Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Bauru, Sao Paulo, Brazil
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3
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Jorge PK, Chagas NV, Ambrosio ECP, Carrara CFC, Valarelli FP, Machado MAAM, Oliveira TM. Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8666343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) – children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) – children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) – children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C’), anterior length of dental arch (I-CC’), and total length of the dental arch (I–MM’), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.
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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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5
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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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Sullivan ZC, Van Eeden S, May J, Flannigan N, Seshu M, Dominguez-Gonzalez S. Identifying associations between dental arch relationship scores, relative deprivation and other cleft audit outcomes. Part 2. Orthod Craniofac Res 2021; 25:103-111. [PMID: 34056824 DOI: 10.1111/ocr.12504] [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] [Received: 11/28/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Abstract
Identify associations between dental arch relationship scores, oral health status and deprivation index in patients with complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). Ninety-two 5-year-old children with non-syndromic complete UCLP and thirty-nine 5-year-old children with non-syndromic complete BCLP from the United Kingdom. Data were collected from the 5-year audit outcomes submitted to the Cleft Registry and Audit Network (CRANE). The index of multiple deprivation (IMD) and Welsh index of deprivation were used to assess a relative measure of deprivation. Comparisons of 5-year-old index/BCLP Deciduous Dentition Yardstick outcome against IMD and dmft are performed using multivariable linear regression models. Both UCLP and BCLP had a high percentage of children with dmft >0 (47% and 49%, respectively). The mean dmft for the UCLP cohort was 2.8 and 2.6 for the BCLP cohort. In the UCLP group, a poorer 5-year-old index was associated with an increased dmft score (P = .023) and higher level of deprivation (P = .010). In the BCLP group, there was no significant associations between BCLP Deciduous Dentition Yardstick, dmft and IMD. A poorer dental arch relationship outcome may be associated with higher level of area deprivation and oral health status, in children with UCLP. Those with a poor outcome for the 5-year-old Index are more likely to have increased caries experience.
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Affiliation(s)
| | | | - Joanna May
- Alder Hey Hospital Children's Hospital, Liverpool, UK
| | - Norah Flannigan
- Orthodontic department, Liverpool University Dental Hospital, Liverpool, UK
| | - Madhavi Seshu
- Alder Hey Hospital Children's Hospital, Liverpool, UK
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7
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Sullivan ZC, Van Eeden S, McMahon S, Edwards Z, Flannigan N, Seshu M, Dominguez-Gonzalez S. Identifying associations between dental arch relationship scores, relative deprivation and other cleft audit outcomes. Part 1. Orthod Craniofac Res 2021; 25:82-95. [PMID: 33998764 DOI: 10.1111/ocr.12495] [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: 11/28/2020] [Revised: 04/05/2021] [Accepted: 04/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess whether dental arch relationship scores are associated with speech, audiological and psychology outcomes in patients with complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). SETTING AND SAMPLE POPULATION One hundred 5-year-old children with non-syndromic complete UCLP and forty-two 5-year-olds with non-syndromic complete BCLP from the United Kingdom. MATERIAL AND METHODS Data were collected from five-year audit clinics for dental arch relationships, speech, hearing and psychology outcomes. Associations were assessed between ordinal prognostic covariates and the dental arch relationship outcome using a Cochrane-Armitage test for trend and comparisons with binary prognostic covariates using chi-square/Fisher's exact test. This was extended to assess associations between five-year audit outcomes and a measure of deprivation. RESULTS There was no evidence of associations between dental arch relationships and outcomes for audiology and speech. Individual domain analysis of the psychology outcomes within the UCLP cohort reported a poor outcome for Pro-social score to be associated with a poor 5-year-old index score (P = .018). For the BCLP sample, a good outcome for the BCLP Deciduous Dentition Yardstick was associated with a good conduct score (P = .01). CONCLUSION There was no association with the 5-year-old index/BCLP Deciduous Dentition Yardstick score and outcomes reported for audiology and speech. For the UCLP and BCLP cohorts, a poor dental arch relationship outcome may be associated with issues with some aspects of psychological well-being, associated with peer interactions and conduct. The deprivation index of samples had no association with the outcomes assessed.
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Affiliation(s)
| | | | | | - Zoe Edwards
- Alder Hey Hospital Children's Hospital, Liverpool, UK
| | - Norah Flannigan
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Madhavi Seshu
- Alder Hey Hospital Children's Hospital, Liverpool, UK
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8
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Pinheiro FHDSL, Frota CM, Garib DG, Sathler R, Ozawa TO, Lauris RDCMC, Kato RM, Kurimori ÉT. A Cleft-Customized Occlusal Rating System to Assess Orthodontic Occlusal Improvement in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 59:54-65. [PMID: 33653126 PMCID: PMC8679178 DOI: 10.1177/1055665621995313] [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: 11/23/2022] Open
Abstract
Objective: This study aimed to develop a new method to quantify occlusal improvement in
patients with unilateral cleft lip and palate (UCLP) who had undergone
orthodontic treatment and to evaluate its reproducibility. Design: A panel of orthodontists decided on the relevance of different occlusal
features to score initial and final 3-dimensional study models and panoramic
radiographs. A subsequent subjective analysis was later performed by a local
orthodontic panel. Setting: The sample was obtained from the orthodontic clinical archives of a hospital
known for the treatment of patients with craniofacial differences. Patients: Thirty-one nonsyndromic patients, 17 males and 14 females, were randomly
selected according to preestablished inclusion/exclusion criteria. Interventions: The records corresponded to the period during which the patients were treated
with conventional multibracket mechanics and adjunctive restorative
procedures. Main Outcome/Measures: The intraclass correlation coefficient measured intraexaminer and
interexaminer agreements. The Spearman correlation test assessed the
relationship between the local orthodontic panel perception and the
improvement scores. Results: Inter- and intra-rater ICCs varied between fair/good to excellent. There was
a strong correlation between the Cleft-Customized Occlusal Rating system
classification of occlusal improvement and the local orthodontic panel’s
perception, thereby enabling the utilization of the interpretation scale by
the panel. Conclusions: The method showed to be a useful tool in quantifying and classifying occlusal
improvement in this specific population. As any other method, some
limitations apply and need to be accounted for.
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Affiliation(s)
| | - Carolina Martins Frota
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, São Paulo, Brazil
| | - Daniela Gamba Garib
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies and Bauru Dental School, University of Sao Paulo, Bauru, São Paulo, Brazil
| | - Renata Sathler
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, São Paulo, Brazil
| | - Terumi Okada Ozawa
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, São Paulo, Brazil
| | | | - Renata Mayumi Kato
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, São Paulo, Brazil
| | - Érika Tiemi Kurimori
- Department of Orthodontics, Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, São Paulo, Brazil
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9
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Bittermann GKP, van Es RJJ, de Ruiter AP, Bittermann AJN, Koole R, Rosenberg AJWP. Retrospective analysis of clinical outcomes in bilateral cleft lip and palate patients after secondary alveolar bone grafting and premaxilla osteotomy, using a new dento-maxillary scoring system. J Craniomaxillofac Surg 2020; 49:110-117. [PMID: 33357967 DOI: 10.1016/j.jcms.2020.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/20/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022] Open
Abstract
Evaluation of relevant clinical outcomes in patients with bilateral cleft lip and palate (BCLP) after secondary aveolar bone grafting (SABG) and premaxilla osteotomy (PMO), through the use of a new scoring system. Data were collected retrospectively from all patients with BCLP who were operated on between 2004 and 2014, at the end of follow-up. The treatment protocol consisted of SABG + PMO in patients aged between 9 and 13 years. At the end of follow-up, the following parameters were scored: (un)interrupted dental arch, skeletal sagittal relationship, bone height using the Bergland/Abyholm criteria, and the presence of postoperative fistula. These parameters were combined to produce a dento-maxillary scoring system, giving a final score between 1 and 10. For statistical analysis, the independent t-test was used. Of 55 children, 45 were suitable for analysis. The mean age at time of surgery was 12.0 years (8.9-16.4 yrs), and the mean follow-up time was 11.7 years (5.8-15.8 yrs). The average number of surgeries executed under general anesthesia was 6 (range: 3-11). The average dento-maxillary score in this patient cohort was 7.6 (1-10; median: 8). Among these patients, 31 had an uninterrupted dental arch; the average Bergland/Abyholm score was 2.07; 30 patients exhibited an Angle class I incisor relationship; and, in 38 cases, the oronasal communication was closed after SABG + PMO treatment. A significant effect of fistulas was seen on dento-maxillary score (p = 0.001). Specifically, a significant effect of fistulas was seen on interrupted dental arch (p = 0.002) and on Bergland/Abyholm score (p = 0.037). The proposed dento-maxillary scoring system is a straightforward tool that can be used to describe and analyze the amount of dento-maxillary rehabilitation at the end of the treatment. Persistence of oronasal fistulas in patients with BCLP has a significant impact on interruption of the dental arch, and can influence dental results at the end of the second decade.
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Affiliation(s)
| | - Robert J J van Es
- Department of Oral and Maxillofacial Surgery, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, the Netherlands
| | - Adrianus P de Ruiter
- Department of Oral and Maxillofacial Surgery, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, the Netherlands
| | - Arnold J N Bittermann
- Department of Pediatric Otorhinolaryngology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB, Utrecht, the Netherlands
| | - Ron Koole
- Department of Oral and Maxillofacial Surgery, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, the Netherlands
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery, Utrecht University, Heidelberglaan 100, PO Box 85500, 3508 AB, Utrecht, the Netherlands
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10
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Ahmed M, Fida M, Jeelani W. Management of an adolescent with complete bilateral cleft lip and palate using fan-shaped expander and secondary alveolar bone graft: A case report. Int Orthod 2020; 18:593-602. [PMID: 32753334 DOI: 10.1016/j.ortho.2020.04.002] [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: 04/10/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 11/26/2022]
Abstract
Treatment approach for bilateral cleft lip and palate (BLCLP) patients varies according to their presenting age. This case report describes the successful orthodontic treatment in an adolescent with BLCLP who was classified in Grade 3 according to Bauru BLCLP yardstick. The patient was diagnosed with skeletal Class III malocclusion, severe crowding, anterior and bilateral posterior crossbites and bilateral maxillary anterior alveolar defects. A combined orthodontic and surgical approach comprising of fan-shaped expander, secondary alveolar bone graft followed by comprehensive orthodontic treatment was utilized. The treatment resulted in a greatly improved facial aesthetics and stomatognathic function, which contributed to psychological well being of the patient.
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Affiliation(s)
- Maheen Ahmed
- Bakhtawar Amin Medical and Dental College, Multan, Pakistan
| | - Mubassar Fida
- Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, P.O. Box 3500, Stadium Road, 74800 Karachi, Pakistan
| | - Waqar Jeelani
- Bakhtawar Amin Medical and Dental College, Multan, Pakistan.
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11
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Fowler PV, Keall H, Kennedy D, Healey D, Thompson JMD. Dental arch relationship outcomes for children with complete unilateral and complete bilateral cleft lip and palate in New Zealand. Orthod Craniofac Res 2019; 22:147-152. [PMID: 30742737 DOI: 10.1111/ocr.12300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate dental arch relationships of patients with complete unilateral and complete bilateral cleft lip and palate (CUCLP/CBCLP) in New Zealand. SETTING AND SAMPLE POPULATION Retrospective nationwide observational outcomes study involving 100 CUCLP and 32 CBCLP non-syndromic patients. MATERIAL AND METHODS Four calibrated assessors, blinded to the origin of the randomized digital models, used the GOSLON (UCLP) and the Bauru-BCLP (BCLP) Yardsticks and a 100 mm visual analogue scale (VAS) (UCLP&BCLP) to assess dental arch relationships. Weighted Kappa statistics were used to determine the intra- and inter-rater reliability for the GOSLON/Bauru-BCLP Yardsticks and correlations for the VAS. RESULTS Intra-rater reliability ranged from 0.57 to 0.88 (GOSLON), 0.62-0.84 (Bauru-BCLP) and 0.45-0.93 (VAS). Inter-rater reliability ranged from 0.62 to 0.86, (GOSLON), 0.48-0.75 (Bauru-BCLP) and 0.64-0.93 (VAS). Of the 100 CUCLP models, 46% had poor/very poor, 28% fair and 26% had good/very good dental arch relationships. Of the 32 CBCLP models, 37.5% were poor/very poor, 40.6% fair and 21.9% had good/very good dental arch relationships. The mean CUCLP VAS score was 50.5 mm (SD 19.9 mm) whilst the mean CBCLP VAS score was 40.0 mm (SD 22.0 mm) and both showed a strong relationship with their respective Yardstick scorings. CONCLUSION The dental arch relationships of children in New Zealand with CUCLP are similar to those centres in the Eurocleft and Americleft studies which had less favourable outcomes. Those with CBCLP are inferior to those reported elsewhere. Continued monitoring will allow for tracking of improvement in outcomes.
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Affiliation(s)
- Peter V Fowler
- Hospital Dental Department, Christchurch Hospital, Christchurch, New Zealand.,Department of Paediatrics, Child and Youth Health, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand
| | - Heather Keall
- Hospital Dental Department, Middlemore Hospital, Auckland, New Zealand
| | - Dan Kennedy
- Hospital Dental Department, Middlemore Hospital, Auckland, New Zealand
| | - David Healey
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - John M D Thompson
- Department of Paediatrics, Child and Youth Health, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand.,Department of Obstetrics & Gynaecology, Faculty of Health Science and Medicine, University of Auckland, Auckland, New Zealand
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Bittermann GK, de Ruiter AP, Bittermann AJN, Mink van de Molen AB, van Es RJJ, Koole R, Rosenberg AJWP. Midfacial growth and dental arch relationships in bilateral cleft palate following secondary alveolar bone grafting and orthodontic intervention: Factors predicting a Le Fort I osteotomy at age 18. J Craniomaxillofac Surg 2018; 46:1764-1771. [DOI: 10.1016/j.jcms.2018.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/03/2018] [Accepted: 07/19/2018] [Indexed: 10/28/2022] Open
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Batra P, Annavarapv GK, Chopra A, Srivastava A, Sadhu P, Mevda K. Use of Bauru Yardstick in Patients With Complete Bilateral Cleft Lip and Palate at an Indian Center. Cleft Palate Craniofac J 2018; 55:602-606. [PMID: 29554457 DOI: 10.1177/1055665617730360] [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: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate dental arch relationship in treated bilateral cleft lip and palate (BCLP) cases at an Indian cleft center using the Bauru yardstick. PATIENTS AND METHODS Digital photographs of the dental cast of 50 consecutively treated patients (28 males and 22 females) with nonsyndromic BCLP at an Indian cleft center were rated by 2 examiners as per the Bauru yardstick for the 12-year-old age group. The average age group was 12 ± 0.62 years. All cases were treated with same surgical protocol. RESULTS The inter-examiner agreement between the 3 examiners was found to be very high, with weighted kappa values ranging from 0.894 to 0.951. The intraexaminer agreement between the 2 examinations for all the examiners was also found to be very high, with weighted kappa values ranging from 0.894 to 0.931. Seventy-eight percent of patients were rated with a Bauru yardstick score of 1+2. In addition, 10% of patients were rated with a score of 3, 8% as 4, and 4% as 5. The overall Bauru yardstick score for the center was 2.36. CONCLUSION The protocol followed for the repair of BCLP cases by the center was found to be a good regimen in regard to the Bauru yardstick score.
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Affiliation(s)
- Puneet Batra
- 1 Department of Orthodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | | | - Ashish Chopra
- 1 Department of Orthodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Amit Srivastava
- 1 Department of Orthodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | | | - Keyur Mevda
- 2 Global Hospital and Research Centre, Mount Abu, Rajasthan, India
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Allori AC, Kelley T, Meara JG, Albert A, Bonanthaya K, Chapman K, Cunningham M, Daskalogiannakis J, De Gier H, Heggie AA, Hernandez C, Jackson O, Jones Y, Kangesu L, Koudstaal MJ, Kuchhal R, Lohmander A, Long RE, Magee L, Monson L, Rose E, Sitzman TJ, Taylor JA, Thorburn G, Van Eeden S, Williams C, Wirthlin JO, Wong KW. A Standard Set of Outcome Measures for the Comprehensive Appraisal of Cleft Care. Cleft Palate Craniofac J 2017; 54:540-554. [DOI: 10.1597/15-292] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Care of the patient with cleft lip and/or palate remains complex. Prior attempts at aggregating data to study the effectiveness of specific interventions or overall treatment protocols have been hindered by a lack of data standards. There exists a critical need to better define the outcomes- particularly those that matter most to patients and their families-and to standardize the methods by which these outcomes will be measured. This report summarizes the recommendations of an international, multidisciplinary working group with regard to which outcomes a typical cleft team could track, how those outcomes could be measured and recorded, and what strategies may be employed to sustainably implement a system for prospective data collection. It is only by agreeing on a common, standard set of outcome measures for the comprehensive appraisal of cleft care that intercenter comparisons can become possible. This is important for quality-improvement endeavors, comparative effectiveness research, and value-based health-care reform.
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Affiliation(s)
- Alexander C. Allori
- Division of Plastic, Maxillofacial & Oral Surgery, Duke Children's Hospital & Health Center, Durham, North Carolina
| | - Thomas Kelley
- Business Development & Partnerships, International Consortium for Health Outcomes Measurement, Boston, Massachusetts
| | - John G. Meara
- Department of Plastic & Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Asteria Albert
- Department of Pediatric Surgery, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | - Kathy Chapman
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Michael Cunningham
- Division of Craniofacial Medicine, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - John Daskalogiannakis
- Department of Orthodontics, Hospital for Sick Children, University of Toronto, Toronto, Canada, and Member, Task Force on Americleft, American Cleft Palate-Craniofacial Association, Lancaster, Pennsylvania
| | - Henriette De Gier
- Department of Otolaryngology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Andrew A. Heggie
- Department of Plastic & Maxillofacial Surgery, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia
| | | | - Oksana Jackson
- Division of Plastic & Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Yin Jones
- Cleft Lip & Palate Association, London, England
| | - Loshan Kangesu
- North Thames Cleft Centre, London, United Kingdom, and Consultant Surgeon, St. Andrews Centre of Plastic Surgery, Broomfield Hospital Chelmsford, Essex, United Kingdom
| | - Maarten J. Koudstaal
- Department of Oral & Maxillofacial Surgery, Dutch Craniofacial Centre, Sophia's Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden, and Professor, Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Ross E. Long
- Lancaster Cleft/Craniofacial Program, Lancaster, Pennsylvania; Professor, Department of Orthodontics, Albert Einstein Medical Center, Philadelphia, Pennsylvania, and Task Force on Americleft, American Cleft Palate-Craniofacial Association, Lancaster, Pennsylvania
| | - Leanne Magee
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Laura Monson
- Department of Plastic Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Elizabeth Rose
- Department of Otolaryngology, Royal Children's Hospital Melbourne, University of Melbourne, Melbourne, Australia
| | - Thomas J. Sitzman
- Department of Plastic Surgery, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Jesse A. Taylor
- Division of Plastic & Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Guy Thorburn
- North Thames Cleft Centre, London, United Kingdom
| | - Simon Van Eeden
- Northwest, North Wales, and Isle of Man Cleft Network, Liverpool, England
| | | | - John O. Wirthlin
- Department of Plastic Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Karen W. Wong
- Division of Plastic & Reconstructive Surgery, Hospital for Sick Children, University of Toronto, Toronto, Canada
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Dissaux C, Grollemund B, Bodin F, Picard A, Vazquez MP, Morand B, James I, Kauffmann I, Bruant-Rodier C. Evaluation of 5-year-old children with complete cleft lip and palate: Multicenter study. Part 2: Functional results. J Craniomaxillofac Surg 2015; 44:94-103. [PMID: 26712484 DOI: 10.1016/j.jcms.2015.08.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/07/2015] [Accepted: 08/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Cleft surgery is marked by all the controversies and the multiplication of protocols, as it has been shown by the Eurocleft study. The objective of this pilot study is to start a comparison and analyzing procedure between primary surgical protocols in French centers. METHODS Four French centers with different primary surgical protocols for cleft lip and palate repair, have accepted to be involved in this retrospective study. In each center, 20 consecutive patients with complete cleft lip and palate (10 UCLP, 10 BCLP per center), non syndromic, have been evaluated at a mean age of 5 [range, 4-6]. In this second part, maxillary growth and palatine morphology were assessed on clinical examination and on dental casts (Goslon score). Speech was also evaluated clinically (Borel-maisonny classification) and by Aerophonoscope. RESULTS Veau-Wardill-Killner palatoplasty involves a higher rate of transversal maxillary deficiency and retromaxillary. The fistula rate is statistically lower with tibial periosteum graft hard palate closure but this technique seems to give retromaxillary. Malek and Talmant two-stage-palatoplasty techniques reach Goslon scores of 1 or 2. Considering speech, Sommerlad intravelar veloplasty got higher outcomes. CONCLUSIONS Primary results. Extension to other centers required. The two-stage palatoplasty, including a Sommerlad intravelar veloplasty seems to have the less negative impact on maxillary growth, and to give good speech outcomes. LEVEL OF EVIDENCE Therapeutic study. Level III/retrospective multicenter comparative study.
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Affiliation(s)
- Caroline Dissaux
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l'Hôpital Civil, 67091 Strasbourg, France.
| | - Bruno Grollemund
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l'Hôpital Civil, 67091 Strasbourg, France
| | - Frédéric Bodin
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l'Hôpital Civil, 67091 Strasbourg, France
| | - Arnaud Picard
- Paediatric Maxillofacial and Plastic Surgery Department, French Cleft Reference Center, Necker Hospital, 75015 Paris, France
| | - Marie-Paule Vazquez
- Paediatric Maxillofacial and Plastic Surgery Department, French Cleft Reference Center, Necker Hospital, 75015 Paris, France
| | - Béatrice Morand
- Maxillofacial and Plastic Surgery Department, Cleft Competence Center, Grenoble University Hospital, Hôpital Michallon, 38043 Grenoble, France
| | - Isabelle James
- Paediatric Plastic Surgery Department, Cleft Competence Center, Clinique du Val d'Ouest, 69130 Ecully (Lyon), France
| | - Isabelle Kauffmann
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l'Hôpital Civil, 67091 Strasbourg, France
| | - Catherine Bruant-Rodier
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l'Hôpital Civil, 67091 Strasbourg, France
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Evaluation of Treatment Outcome in Cleft Maxillary Hypoplasia Treated by Rigid External Distractor. J Craniofac Surg 2014; 25:143-8. [DOI: 10.1097/scs.0000000000000374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Altalibi M, Saltaji H, Edwards R, Major PW, Flores-Mir C. Indices to assess malocclusions in patients with cleft lip and palate. Eur J Orthod 2013; 35:772-82. [PMID: 23504529 DOI: 10.1093/ejo/cjt009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several indices are now available to assess the severity of the malocclusion in cleft lip and/or palate (CLP) patients; and although it has been quite some time since the introduction of these indices, there is no consensus as to which index should be used for CLP populations. OBJECTIVE To systematically review the available literature on the indices used to assess the occlusal schemes in dental models of CLP patients, with respect to the most commonly used index and the index that most fulfils the World Health Organization (WHO) criteria. SEARCH METHODS Ten electronic databases, grey literature, and reference list searches were conducted. SELECTION CRITERIA The inclusion criteria consisted of studies that aimed to assess a particular malocclusion index on study models of patients with CLP. DATA COLLECTION AND ANALYSIS Full articles were retrieved from abstracts/titles that appeared to have met the inclusion -exclusion criteria which were subsequently reviewed using more detailed criteria for a final selection decision. The Quality Assessment of Diagnostic Accuracy Studies tool was used to appraise the methodological quality of the finally included studies. Due to the heterogeneity of the data, only a qualitative analysis was performed. RESULTS A total of 13 studies met the inclusion -exclusion criteria. These studies revealed seven utilized indices, namely the GOSLON Yardstick, Five-Year-Old, Bauru-Bilateral Cleft Lip and Palate Yardstick, Huddart -Bodenham, Modified Huddart -Bodenham, EUROCRAN Yardstick, and GOAL Yardstick. The GOSLON Yardstick was the most commonly used index, and the Modified Huddart -Bodenham performed the best according to the WHO criteria. CONCLUSIONS Current evidence suggests that the Modified Huddart -Bodenham Index equalled or outperformed the rest of the indices on all the WHO criteria and that the GOSLON Yardstick was the most commonly used index, possibly due to a longer time in use. Therefore, the Modified Huddart -Bodenham could be considered as the standard to measure outcomes of patients with CLP.
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Affiliation(s)
- Mostafa Altalibi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Freitas JADS, Garib DG, Oliveira M, Lauris RDCMC, Almeida ALPFD, Neves LT, Trindade-Suedam IK, Yaedú RYF, Soares S, Pinto JHN. Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies-USP (HRAC-USP)--part 2: pediatric dentistry and orthodontics. J Appl Oral Sci 2012; 20:268-81. [PMID: 22666849 PMCID: PMC3894774 DOI: 10.1590/s1678-77572012000200024] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 04/11/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies-University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.
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Affiliation(s)
- José Alberto de Souza Freitas
- Hospital for Rehabilitation of Craniofacial Anomalies, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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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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A New Yardstick for Rating Dental Arch Relationship in Patients With Complete Bilateral Cleft Lip and Palate. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.yprs.2011.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Leenarts CMR, Bartzela TN, Bronkhorst EM, Semb G, Shaw WC, Katsaros C, Kuijpers-Jagtman AM. Photographs of dental casts or digital models: rating dental arch relationships in bilateral cleft lip and palate. Int J Oral Maxillofac Surg 2011; 41:180-5. [PMID: 22154575 DOI: 10.1016/j.ijom.2011.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 02/11/2011] [Accepted: 11/08/2011] [Indexed: 11/15/2022]
Abstract
Yardsticks have been developed to measure dental arch relations in cleft lip and palate (CLP) patients as diagnostic proxies for the underlying skeletal relationship. Travelling with plaster casts to compare results between CLP centres is inefficient so the aim of this study was to investigate the reliability of using digital models or photographs of dental casts instead of plaster casts for rating dental arch relationships in children with complete bilateral cleft lip and palate (CBCLP). Dental casts of children with CBCLP (n=20) were included. Plaster casts, digital models and photographs of the plaster casts were available for all the children at 6, 9, and 12 years of age. All three record formats were scored using the bilateral cleft lip and palate (BCLP) yardstick by four observers in random order. No significant differences were found for the BCLP yardstick scores among the three formats. The interobserver weighted kappa scores were between 0.672 and 0.934. Comparison between the formats per observer resulted in weighted kappa scores between 0.692 and 0.885. It is concluded that digital models and photographs of dental casts can be used for rating dental arch relationships in patients with CBCLP. These formats are a reliable alternative for BCLP yardstick assessments on conventional plaster casts.
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Affiliation(s)
- C M R Leenarts
- Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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