The data suggest favorable outcomes, with 75 % of cases with no need of orthognathic surgery. The Kappa values confirmed the high reproducibility of the GOSLON yardstick.

The aim of this study was to investigate the effect of orthodontic treatment on the maxillofacial growth of patients with unilateral cleft lip and palate. The Great Ormond Street, London and Oslo (GOSLON) yardstick was used for a longitudinal evaluation of 24 patients with cleft lip and palate treated at the Cleft Center of the Lauro Wanderley University Hospital, Paraiba State, northeastern Brazil. Dental casts were evaluated by 3 orthodontists and classified according to the GOSLON yardstick. The evaluation was performed at 2 different stages: T1 (before orthodontic treatment) and T2 (follow-up evaluation) after a 6-year mean follow-up interval. The Kappa test was used to evaluate intra- and interexaminer agreement, and paired t-test was used to compare the differences between T1 and T2, with a 99% confidence interval. The average intraexaminer Kappa was 0.979, ranging from 0.971 to 0.990. The interexaminer Kappa value was 0.926 at T1, ranging from 0.885 to 0.964, and 0.896 at T2, ranging from 0.696 to 1.0. The mean GOSLON yardstick found at T1 was 2.5 ± 1.18 with 50% in G1 + G2, 29.18% in G3, and 20.82% in G4 + G5. At T2, the GOSLON average was 1.71 ± 1.12, with 79.18% in G1 + G2, 12.5% in G3, and 8.32% in G4 + G5. A statistically significant difference was found between T1 and T2. The results suggest that orthodontic treatment improves facial growth in patients with unilateral cleft lip and palate.

recommended a 12-months-interval follow up through clinical examination, ultrasound and CT scan.

Objective: Cleft lip and/or palate is the most common congenital anomaly in a human face, with a multifactorial and complex etiology. Although many studies have been developed, the role of the environment is still unclear. This study aims to test the hypothesis that differences in lifestyle and environment change the reproductive risks of orofacial clefts.Methods: A total of 2,422 medical records of individuals born with cleft lip and/or palate in a reference center in the northeast of Brazil over a period of 30 years were analyzed. Data on the cleft type, geographic origin of the patient (coast or inland), presence of associated congenital anomalies or syndromes, maternal age, and maternal parity were recorded. Differences in frequencies between the cleft types were compared based on geographic origin, maternal age, and parity. Chi-square, Student's t, Kruskal–Wallis, and logistic regression were used to analyze the interference of covariables on the cleft type.Results: The distribution of cleft types was significantly different between the coastal and inland areas (chi-square test, p < 0.0001). A higher frequency of cleft lip with or without palate was observed the inland area (chi-square test, p = 0.0006), while cleft palate only (chi-square test, p = 0.003) and rare facial clefts (chi-square test, p = 0.004) were more frequent in the coastal area. No difference was found in the distribution of maternal age (t-test, p > 0.05) between the two geographic areas, but parity was higher inland (t-test, p = 0.04). Logistic regression suggested that parity explained just a small portion of the differences in frequency between cleft types of the coast vs. inland.Conclusion: Frequency of orofacial cleft types differs by geographic area in this region of the South American continent.