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.
Nasal obstruction represents a considerable portion of the symptoms addressed by the otolaryngologist. It has received widespread interest in the orthodontic literature as well, because of the presumed relation between nasal obstruction and facial growth, especially vertical maxillary excess. The range of normal variation in oral versus nasal breathing has not been defined. This study attempted to correlate patient symptoms with respiratory mode. A sample of 20 symptomatic adult subjects presenting with nasal obstruction was compared to a control sample of 20 asymptomatic adults by means of SNORT (Simultaneous Nasal and Oral Respirometric Technique). Nasal resistance was significantly different between the two groups, but percent nasality (that proportion of the total volume of air breathed nasally) was a more consistent and significant finding. The relevance of these results to both clinical and basic physiology is discussed.
The authors aimed to accurately assess the donor site morbidity from iliac crest bone grafts for secondary bone grafting in patients with cleft lip and palate alveolar defects. Fifty patients between 3 months and 10 years following alveolar bone grafting for cleft lip and palate were entered into the study. Two-thirds of patients had no significant concerns about the donor site. The remaining third had some concerns about the appearance of their hips and less than 10% of patients expressing strong agreement with statements about concerns with shape, appearance, and self-consciousness about the iliac crest donor site. Examination findings showed the average length of scar being 5.4 cm and a third of patients having some minor palpable boney irregularities of the iliac crest. The authors found that the alveolar crest donor site is well tolerated by patients long term but has a measurable morbidity long term.
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