Prediction of orthognathic surgery need in children with unilateral cleft lip palate: Dental arch relationships and 5‐year‐olds' index

Abstract

Objective To evaluate whether dental arch relationships at 6 years of age can categorize treatment outcome and predict later need for orthognathic surgery in children with unilateral cleft lip and palate (UCLP). Setting and sample population A retrospective longitudinal single‐centre study. The study sample comprised 70 consecutive non‐syndromic children (47 boys) with complete UCLP operated on by pushback techniques during 1981‐1989 and followed until early adulthood in the same cleft centre. Materials and methods Dental casts and maxillomandibular relationships were assessed before orthodontic treatment and secondary alveolar bone grafting at mean age 6.1 years (range 5.6‐6.8) using the 5‐year‐olds' index and lateral cephalograms. The need for orthognathic surgery was retrieved from patient files. Student's t test, Pearson's correlation, and Kappa statistics were used in statistical analyses. Results Orthognathic surgery frequency was 41% (29/70). Those needing orthognathic surgery comprised all 3 patients with an index score of 5 (very poor), 14 of 17 (82%) scoring 4 (poor), 10 of 26 (38%) scoring 3 (fair), and 2 of 19 (11%) scoring 2 (good). Of the five patients with index score 1 (excellent), none needed osteotomies. The mean index score was 2.9. The score was significantly better in those without orthognathic surgery (2.4 versus 3.6). A significant negative correlation existed between the 5‐year‐olds' index and cephalometric angles ANB and anb. Conclusion The use of 5‐year‐olds' index may help to predict treatment outcome and the clinical need for orthognathic surgery especially in patients with the lowest and highest index scores.

Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: comparison of dental arch relationships and dental indices at 5, 8, and 10 years

“…In the Eurocleft study, patients with UCLP with GOSLON scores of 3.5 and higher were considered candidates likely to require maxillary osteotomy at the completion of growth ( 19 ). In a retrospective longitudinal single-centre study with 70 patients with ULCP ( 36 ), the 5YO index score at 6 years of age was significantly worse in those with later orthognathic surgery (3.6 versus 2.4).…”

“…Of the 5-year-olds allocated to group 3, 4, or 5, 60% had a good or fair dental arch relationship at 19 years. The use of the 5YO index before orthodontic treatment may help to predict outcome and clinical need for orthognathic surgery, especially in patients with the lowest and highest index scores ( 36 ).…”

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

“…Виконання реконструктивних втручань на коміркових відростках верхніх щелеп на стороні незрощення є необхідним етапом комплексної реабілітації пацієнта, яке позитивно впливає на симетрію середньої третини обличчя, стабілізує та нормалізує положення крила носа, відновлює ізоляцію носової та ротової порожнин, забезпечує оптимальні умови для проведення ортодонтичного лікування та зубного протезування (за потреби). На сьогодні фіксація процесу реабілітації пацієнта з уродженими вадами за допомогою фотографії є важливим компонентом оцінки результатів лікування, тому аналіз результатів клінічних фото є способом математичного моделювання, яке спрощує сприйняття клінічної ситуації [11][12][13][14][15].…”