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van der Knaap-Kind LS, Ombashi S, Van Roey V, Kragt L, Peterson P, Jabbari F, Wolvius EB, Versnel SL. Evaluation and recommendations of the oral health, oral function, and orofacial aesthetics-related measures of the ICHOM Standard Set for Cleft Lip and Palate. Int J Oral Maxillofac Surg 2024; 53:563-570. [PMID: 38228465 DOI: 10.1016/j.ijom.2024.01.001] [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] [Received: 05/26/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
This study was performed to evaluate the efficacy of outcome measures for the orofacial domain included in the International Consortium for Health Outcomes Measurement Standard Set for Cleft Lip and Palate (ICHOM-SCS). In this multicentre study involving two cleft centres, suggestions to optimize the type and timing of outcome measures were made based on data and clinical experience. Patient-reported outcome measures (PROMs) (CLEFT-Q Jaw, Teeth, Eating/Drinking; Child Oral Health Impact Profile-Oral Symptoms Scale (COHIP-OSS)) and clinical outcome measures (caries experience and dental occlusion) data were collected retrospectively for age 5, 8, 10, 12, 19, and 22 years. The data were categorized by cleft type and analysed within and between age groups using Spearman correlation, the distribution of responses per item, a two-sample test for equality of proportions, and effect plots. Most correlations between PROMs and clinical outcome measures were weak (r < 0.5), suggesting PROMs and clinical outcome measures complement each other. The COHIP-OSS and CLEFT-Q Eating/Drinking barely detected problems in any patient category and are no longer recommended. A suitable alternative appears complex to find; outcomes of this study and the recent literature doubt an added value. Similar problems were found in the CLEFT-Q Jaw at time-point 12 years. Therefore, time-points 15 and 17 years are currently suggested.
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Affiliation(s)
- L S van der Knaap-Kind
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - S Ombashi
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - V Van Roey
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - L Kragt
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - P Peterson
- Department of Reconstructive Plastic Surgery, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - F Jabbari
- Department of Dental Medicine, Orthodontics and Paediatric Dentistry, Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - E B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; European Reference Network for Rare and/or Complex Craniofacial Anomalies and Ear, Nose And Throat Disorders, Erasmus University Medical Center, Rotterdam, the Netherlands
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Khawer MS, Da Silva K. The oral health-related quality of life of children with fetal alcohol spectrum disorder. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38472635 DOI: 10.1111/scd.12993] [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: 12/21/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION A child's oral health impacts their development and quality of life. Children who live with fetal alcohol spectrum disorder (FASD) face barriers to dental care combined with poorer oral health outcomes. However, how this affects their oral health-related quality of life (OHRQoL) is largely unknown. Thus, the aim of this study is to examine the OHRQoL of children living with FASD. METHODS This cross-sectional survey used the Child Oral Health Impact Profile-Short Form-19 (COHIP-SF-19) to evaluate the OHRQoL quality of life of children (aged 8 to 15) living with FASD, compared to healthy controls. RESULTS A total of 332 children (or their caregivers) completed the survey. The survey results showed that children living with FASD reported significantly more untreated dental conditions. The majority of children in the control group experienced a low impact across the majority of COHIP-SF-19 domains. However, children living with FASD experienced significantly higher impact scores related to oral health, functional well-being, and social-emotional well-being. CONCLUSION The results demonstrated that children who live with FASD have a poorer OHRQoL. Overall, more investigation is necessary to identify the best ways to improve the OHRQoL of children living with FASD.
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Affiliation(s)
- Mohammad Saad Khawer
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Goida J, Pilmane M. The presence and distribution of various genes in postnatal CLP-affected palatine tissue. Maxillofac Plast Reconstr Surg 2024; 46:1. [PMID: 38227085 DOI: 10.1186/s40902-024-00412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Worldwide cleft lip with or without a cleft palate (CL/P) is the most common craniofacial birth defect. Apart from changes in facial appearance, additionally affected individuals often suffer from various associated comorbidities requiring complex multidisciplinary treatment with overall high expenses. Understanding the complete pathogenetic mechanisms of CL/P might aid in developing new preventative strategies and therapeutic approaches, help with genetic counselling, and improve quality of life. Many genes have been associated with the development of orofacial clefts; however, the majority require further research. Based on the role of PAX7, PAX9, SHH, SOX3, WNT3A, and WNT9B in orofacial development, the intention was to use chromogenic in situ hybridization to detect the six genes in postnatal CLP-affected palatine tissue and compare their distribution within the tissue samples. RESULTS Statistically significant differences in the distribution of PAX7, PAX9, WNT3A, and WNT9B were observed. In total, 19 pairs of moderate to very strong positive correlations were noted. CONCLUSIONS Changes in the cleft-affected palatine epithelium primarily seem to be associated with the PAX7 gene; however, PAX9, WNT3A, WNT9B, and SOX3 role seems to be more limited. Whilst connective tissue changes seem to depend on PAX7 only, SHH seems to participate individually and indistinctly. Numerous positive correlations reflect the complicating interactions of the pathways and their components in the orofacial cleft morphopathogenesis.
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Affiliation(s)
- Jana Goida
- Institute of Anatomy and Anthropology, Riga Stradins University, Riga, LV-1010, Latvia.
| | - Mara Pilmane
- Institute of Anatomy and Anthropology, Riga Stradins University, Riga, LV-1010, Latvia
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Defabianis P, Guagnano R, Romano F. A Cross-Sectional Study of the Dental Arch Relationship and Palatal Morphology after Cleft Surgery in Italian Children with Unilateral Cleft and Lip Palate. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1559. [PMID: 37761520 PMCID: PMC10528838 DOI: 10.3390/children10091559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Dental arch relationships (DARs) and palatal morphology (PM) were evaluated in in non-syndromic complete unilateral cleft lip and palate (UCLP) Italian patients after surgery. Pre- and postnatal factors affecting the results were investigated. Sixty-six children with UCLP (40 boys and 26 girls, with a mean age of 10.1 ± 2.9 years), predominantly Caucasian (77%), were consecutively enrolled in this cross-sectional study. Twenty children had received a one-stage protocol consisting of an early periosteal palate surgical repair and lip closure and forty-six were submitted to a staged surgical protocol with delayed palate repair (DPR). A single clinician collected data on their medical history and carried out a dental examination. The DAR and PM were graded on dental casts according to the Eurocran index and dichotomised as favourable and unfavourable based on the treatment outcome. Multiple logistic regression analyses demonstrated that female sex (OR = 6.08, 95% CI: 1.47-25.23, p = 0.013), DPR (OR = 4.77, 95% CI: 1.14-19.93, p = 0.032) and the use of a neonatal plate (OR = 4.68, 95% CI: 1.27-17.16, p = 0.020) increased the odds of having favourable DAR, while only DPR (OR = 9.76, 95% CI: 2.40-39.71, p = 0.001) was significantly associated with a favourable PM. Based on these findings, only DPR had a significantly favourable effect on both DAR and DM in Italian children with complete UCLP.
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Affiliation(s)
- Patrizia Defabianis
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
| | | | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy;
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Alshammari AK, AlDakhayel S, Alsulaiman G, Alzoori F, Alghurayes A, Alshammari T, Algharbi M, Siddiqui AA. Impact of Orofacial Clefts on Oral Health Quality of Life: A Cross-sectional Survey Study in Saudi Arabia. J Contemp Dent Pract 2023; 24:655-659. [PMID: 38152938 DOI: 10.5005/jp-journals-10024-3531] [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: 12/29/2023]
Abstract
AIM To evaluate the effect of facial clefts on the dental health quality of life of affected individuals, and to determine whether age and gender affect the oral health quality of life differently. MATERIALS AND METHODS The cross-sectional survey included 50 participants (32 females and 18 males) from the northern region of Saudi Arabia, using a reliable and validated questionnaire, the Child Oral Health Impact Profile (COHIP), which measured self-reported oral health-related quality of life (OHRQoL) in children and adults using a five-point Likert scale. Statistical analysis was performed, and results were considered significant if the p-value was less than 0.05. RESULTS The highest scores in the oral health domain were related to bad breath and reluctance in speaking or reading aloud in class within the school environment domain, with mean scores of 3.44 ± 1.3 and 3.52 ± 1.2, respectively. Most patients showed apprehension regarding necessary dental treatments (mean = 1.44 ± 0.07). The study found a non-statistically significant difference in tooth discomfort between age groups (p = 0.092), with individuals aged from 20 to 29 experiencing higher levels of discomfort than other age groups surveyed. CONCLUSION The two topics with the highest mean scores in the oral health domain and the school environment domain were bad breath and not wanting to speak or read aloud in class. Females reported more discomfort, and there was a substantial association between gender and tooth pain/sensitivity. CLINICAL SIGNIFICANCE Understanding the difficulties cleft patients face is crucial, as doing so will enable dentists to encourage and handle these issues more effectively.
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Affiliation(s)
- Abdulrahman K Alshammari
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Kingdom of Saudi Arabia, Phone: +966 598092207, e-mail:
| | - Safanah AlDakhayel
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | | | - Fatemah Alzoori
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | | | - Taif Alshammari
- Dental Intern, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Muteb Algharbi
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Ammar A Siddiqui
- Department of Preventive dentistry, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
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Influence of Cleft Lip and Palate on Oral Health-Related Quality of Life in Northern Italy: Exploring Both the Children's and Caregivers' Perspectives. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121986. [PMID: 36553429 PMCID: PMC9776790 DOI: 10.3390/children9121986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
The aim of this cross-sectional study was to examine whether parents/caregivers' perceptions of oral health-related quality of life (OHRQoL) differ from that of their cleft children, exploring the impact of demographic variables and cleft type on their agreement. Fifty-three primary and secondary schoolchildren, with non-syndromic orofacial cleft, and their parents answered the Child Oral Health Impact Profile (COHIP) questionnaire. Concordance between caregivers' and children's reports was low to moderate. Parents/caregivers had worse perceptions of OHRQoL compared to that of their children, peer interaction and functional well-being domains being statistically significantly different (p = 0.033 and p = 0.005, respectively). Cleft type, gender and parents' country of origin seemed to be potential contributing factors of disagreement. Parents overestimated the impact of unilateral (p = 0.047) and bilateral cleft lip and palate (p = 0.021) on OHRQoL, and they rated more poorly than their male children did. Italian parents were more concerned about the functional well-being of their children (p = 0.014), and foreign parents about peer interaction (p = 0.010) and school environment (p = 0.012) dimensions. These findings suggest that parental assessment of OHRQoL cannot replace that of school-aged children, but they are complementary as they cover different, but equally relevant perspectives.
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