Predictors of poor dental arch relationship in young children with unilateral cleft lip and palate

Abstract

The aim of this cross-sectional outcome study using retrospective data capture of treatment histories was to examine the characteristics of young children with unilateral cleft lip and palate who had poor dental arch relationship (i.e., Goslon 5). The study sample comprised 120 children born with nonsyndromic complete unilateral cleft lip and palate between 1995 and 2003, and were aged between 5.0 and 7.0 years (mean age, 5.1 years) at the time of data collection. The dental arch relationship was assessed using the Goslon yardstick from intraoral dental photographs. An independent investigator recorded treatment histories from the clinical notes. The inter- and intraexaminer agreements evaluated by weighted kappa statistics were high. There was no association between dental arch relationship and the type of presurgical orthopedics or pharyngeal flap. Dental arch relationship was associated with the initial cleft size (odds ratio, OR = 1.3; 95% confidence interval, CI = 1.1-1.5, p < 0.01), surgeon grade for palate repair (OR = 5.0, 95% CI = 1.2-19.9, p < 0.05), and primary gingivoperiosteoplasty (OR = 2.8, 95% CI = 1.0-8.1, p = 0.05). These data suggest that intraoral dental photographs provide a reliable method for rating dental arch relationship. Wide initial cleft, high-volume surgeon, and primary gingivoperiosteoplasty are predictors of poor dental arch relationship outcome in young children with unilateral cleft lip and palate. These findings may improve treatment outcome by modifying the treatment protocol for patients with unilateral cleft lip and palate.

Preoperative Cleft Lip Measurements and Maxillary Growth in Patients with Unilateral Cleft Lip and Palate

“…Individual treatment planning based on presenting morphology could be adopted for every cUCLP-affected child rather than conforming to predetermined surgical treatment protocols (Reiser et al, 2010). For example, in the case of a child with severe cUCLP, prone sleep positioning and delayed or staged palate closure might be preferred (Hsieh et al, 2012). This information, if available at birth, can help both parents and those involved in the care of children with clefts better prepare themselves for the eventual outcomes.…”

“…Several studies have suggested that patients with more severe palatal or alveolar clefts or greater palatal tissue deficiency exhibit less favorable maxillary growth and poorer dental arch relationships (Schwartz et al, 1984; Suzuki et al, 1993; Peltomäki et al, 2001; Honda et al, 2002; Liao and Mars, 2005; Liao et al, 2010; Chiu et al, 2011; Chiu and Liao, 2012; Hsieh et al, 2012; Tomita et al, 2012). However, other studies do not support this idea (Johnson et al, 2000; Meazzini et al, 2008, 2011; Reiser et al, 2010; Wiggman et al, 2013).…”

Preoperative Cleft Lip Measurements and Maxillary Growth in Patients With Unilateral Cleft Lip and Palate

“…Several studies have suggested that patients with more severe palatal or alveolar clefts or greater palatal tissue deficiency exhibit less favorable maxillary growth and poorer dental arch relationships (Schwartz et al, 1984;Suzuki et al, 1993;Peltom¨aki et al, 2001;Honda et al, 2002;Liao and Mars, 2005;Liao et al, 2010;Chiu et al, 2011;Chiu and Liao, 2012;Hsieh et al, 2012;Tomita et al, 2012). However, other studies do not support this idea (Johnson et al, 2000;Meazzini et al, 2008Meazzini et al, , 2011Reiser et al, 2010;Wiggman et al, 2013).…”

Effects of early and late cheiloplasty on anterior part of maxillary dental arch development in infants with unilateral complete cleft lip and palate

“…Based on the results of many studies and scientific evidence it can be concluded that POT had not a lasting positive impact on the growth of the dentoalveolar arch (Suri & Tompson, 2004; Hsieh, Liao & Shetty, 2012). The POT using in cleft malformations treatment remains largely unsolved problem.…”