Final Posttreatment Occlusion in Patients With Unilateral Cleft Lip and Palate

Abstract

Objective: To evaluate final posttreatment occlusion in patients with complete unilateral cleft lip and palate (cUCLP) by comparing (1) 3 treatment centers, (2) males and females, (3) cleft and noncleft sides, (4) right- and left-sided clefts, and (5) orthodontic treatment with/without orthognathic surgery (OS). Design: Retrospective cohort study. Patients: Blinded posttreatment dental casts of 56 patients (19.4 ± 1.4 years) with cUCLP from 3 centers in Switzerland. Main Outcome Measure: Occlusal assessment using the modified Huddart/Bodenham (MHB) index. Results: Our sample comprised 35 males and 21 females, 46 with left- and 10 with right-sided clefts, of which 32 had undergone OS. The final posttreatment occlusion showed a median MHB score of 0 (interquartile range: −1.0 to 2.0) in the total sample and did not seem to depend on treatment center, sex, or OS. The MHB scores for the anterior buccal and the buccal segments were more negative on the cleft than on the noncleft side ( P = .002 and P = .006, respectively). When the cleft was on the left side, the MHB score tended to be more positive in the labial ( P = .046) and anterior buccal segments ( P = .034). Conclusions: This study shows a very satisfactory final posttreatment occlusion in patients with cUCLP. The more constricted buccal occlusion on the cleft side emphasizes the attention that should be given in correcting the more medially positioned lesser maxillary segment. The influence of cleft-sidedness should be analyzed further on a sample including more patients with right-sided clefts.

Sidedness in unilateral orofacial clefts: A systematic scoping review

“…Right UCLP was noted to have a stronger correlation with dental arch symmetry in a small Brazilian series 49 . Dental arch relationships with sidedness of cleft were inconclusive; in the study by Staudt et al 50 greater maxillary growth for left sided UCLP was reported using Modified Huddart Bodenham scores and overjet whereas Haque et al 51 reported no difference in GOSLON scores between left or right sided UCLP.…”

“…We report a trend in results reported for either worse outcomes in right sided UCL/P or equivalent outcomes by UCL/P sidedness, with the proviso that a quality analysis was not performed. Anatomical and growth studies reporting worse outcomes for right sided UCL/P have reported a greater degree of hypoplasia in multiple tissue types compared to left sided UCL/P 41,47,48,50 . Going forward it may help to advance our knowledge of outcomes in patients with UCL/P if awareness is raised amongst the community that sidedness in UCL/P could have a greater impact than purely in the administrative nomenclature of cleft classification.…”

Anthropometric Characteristics of the Face in Patients with Congenital Defects of Alveolar Process on Maxilla before Surgical Intervention

“…осіб із уродженими вадами ЩЛД. Тобто, в середньому, реєструвалося народження одної дитини на 420-450 новонароджених [1][2][3][4].…”

Should left‐ and right‐sided unilateral cleft lip and palate patients be grouped together when reporting the outcomes?

“…Previous studies that investigated the association of cleft laterality with school grades in a Norwegian population reported no differences between cleft laterality, whereas two additional studies by the same author that examined the relationship between laterality and academic achievement gave conflicting findings of worse outcomes in left and right clefts 8–10 . When final post‐treatment occlusion in 56 patients with complete UCLP were compared among the right‐ and left‐sided clefts, the outcomes were worse in right‐sided clefts when assessing the labial segment 11 . Regarding facial aesthetics, a retrospective analysis of 76 images of 5‐year‐old patients with a complete UCLP found that surgeon raters scored the aesthetic outcome of right‐sided clefts more severely than those on the left 12 .…”

“…[8][9][10] When final post-treatment occlusion in 56 patients with complete UCLP were compared among the right-and left-sided clefts, the outcomes were worse in right-sided clefts when assessing the labial segment. 11 Regarding facial aesthetics, a retrospective analysis of 76 images of 5-year-old patients with a complete UCLP found that surgeon raters scored the aesthetic outcome of right-sided clefts more severely than those on the left. 12 Similarly, a study rating the appearance of 160 children and teenagers reported patients with right UCLP as having poorer appearance than left UCLP.…”