Dental Arch Relationship Outcomes in Children with Complete Unilateral Cleft Lip and Palate Treated at Princess Margaret Hospital for Children,Perth,Western Australia

Abstract

Objectives

To (1) audit dental arch relationships of all children born between 1982 and 1999 with complete unilateral cleft lip and palate (UCLP) treated at the Cleft Lip and Palate Unit, Princess Margaret Hospital for Children (PMH), Perth, Western Australia, (2) assess the distribution of GOSLON ratings from dental casts taken at 9 years, (3) compare the 9-year GOSLON ratings for “High” and “Low” caseload surgeons, and (4) compare the 9-year PMH GOSLON ratings with published ratings from other units.

Design

Retrospective audit of dental casts and medical charts.

Patients

Dental casts were retrieved for 71 children (47 boys and 24 girls) at 9 years of age.

Main Outcome Measures

GOSLON ratings.

Results

Sixty-eight percent of patients had an excellent to satisfactory dental arch relationship (GOSLON Yardstick ratings 1 to 3) at 9 years with a mean rating of 2.85. High caseload surgeons achieved statistically better mean GOSLON ratings than low caseload surgeons (2.72 and 3.33, respectively).

Conclusions

PMH Cleft Unit's dental arch relationship outcomes are comparable to published series of units using similar treatment protocols. High caseload surgeons achieved better dental arch relationships than low caseload surgeons.

Keywords

dental arch relationships GOSLON Yardstick multicenter comparisons treatment outcome unilateral cleft lip and palate

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References

Altman

Practical Statistics for Medical Research. London: Chapman and Hall; 1991.

Asher-McDade

Brattstrom

Dahl

McWilliam

Moisted

Plint

D.A.

Prahl-Andersen

Semb

Shaw

W.C.

The

R.P.S.

A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 4. Assessment of nasolabial appearance. Cleft Palate Craniofac J. 1992; 29: 409–412.

Asher-McDade

Roberts

Shaw

W.C.

Gallager

Development of a method for rating nasolabial appearance in patients with clefts of the lip and palate. Cleft Palate Craniofac J. 1991; 28: 385–390.

Bearn

Mildinhall

Murphy

Murray

J.J.

Sell

Shaw

W.C.

Williams

A.C.

Sandy

J.R.

Cleft lip and palate care in the United Kingdom—the Clinical Standards Advisory Group (CSAG) Study. Part 4: outcome comparisons, training, and conclusions. Cleft Palate Craniofac J. 2001; 38: 38–43.

Bongaarts

C.A.M.

Van't Hof

M.A.

Prahl-Andersen

Dirks

I.V.

Kuijpers-Jagtman

A.M.

Infant orthopedics has no effect on maxillary arch dimensions in the deciduous dentition of children with complete unilateral cleft lip and palate (Dutchcleft). Cleft Palate Craniofac J. 2006; 43: 665–672.

Chan

K.T.

Hayes

Shusterman

Mulliken

J.B.

Will

L.A.

The effects of active infant orthopedics on occlusal relationships in unilateral complete cleft lip and palate. Cleft Palate Craniofac J. 2003; 40: 511–517.

Chapman

K.L.

Hardin-Jones

M.A.

Goldstein

J.A.

Halter

K.A.

Havlik

R.J.

Schulte

Timing of palatal surgery and speech outcome. Cleft Palate Craniofac J. 2008; 45: 297–308.

Choudhary

Cadier

M.A.

Shinn

D.L.

Shekhar

McDowall

R.A.

Effect of Veau-Wardill-Kilner type of cleft palate repair on long-term midfacial growth. Plast Reconstr Surg. 2003; 111: 576–582.

Fudalej

Hortis-Dzierzbicka

Dudkiewicz

Semb

Dental arch relationship in children with complete unilateral cleft lip and palate following Warsaw (one-stage repair) and Oslo protocols. Cleft Palate Craniofac J. 2009; 46: 648–653.

10.

Hathorn

Roberts-Harry

Mars

The Goslon yardstick applied to a consecutive series of patients with unilateral clefts of the lip and palate. Cleft Palate Craniofac J. 1996; 33: 494–496.

11.

Holland

Gabbay

J.S.

Heller

J.B.

O'Hara

Hurwitz

Ford

M.D.

Sauder

A.S.

Bradley

J.P.

Delayed closure of the hard palate leads to speech problems and deleterious maxillary growth. Plast Reconstr Surg. 2007; 119: 1302–1310.

12.

Johnston

C.D.

Leonard

A.G.

Burden

D.J.

McSherry

P.F.

A comparison of craniofacial form in Northern Irish children with unilateral cleft lip and palate treated with different primary surgical techniques. Cleft Palate Craniofac J. 2004; 41: 42–46.

13.

Kitagawa

Kohara

Sohmura

Takahashi

Tachimura

Wada

Kogo

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage Furlow and push-back method: preliminary results. Cleft Palate Craniofac J. 2004; 41: 519–525.

14.

Landis

J.R.

Koch

G.G.

The measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159–174.

15.

Liao

Y.F.

Cole

T.J.

Mars

Hard palate repair timing and facial growth in unilateral cleft lip and palate: a longitudinal study. Cleft Palate Craniofac J. 2006; 43: 547–556.

16.

Liao

Y.F.

Mars

Hard palate repair timing and facial morphology in unilateral cleft lip and palate: before versus after pubertal peak velocity age. Cleft Palate Craniofac J. 2006; 43: 259–265.

17.

Lilja

Mars

Elander

Enocson

Hagberg

Worrell

Batra

Friede

Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure. Cleft Palate Craniofac J. 2006; 43: 606–611.

18.

Lohmander

Persson

A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J. 2008; 45: 32–41.

19.

Mars

Asher-McDade

Brattstrom

Dahl

McWilliam

Moisted

Plint

D.A.

Prahl-Andersen

Semb

Shaw

W.C.

. A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 3. Dental arch relationships. Cleft Palate Craniofac J. 1992; 29: 405–408.

20.

Mars

Atack

Worrell

Goslon Yardstick: Calibration Course Guidelines. Great Ormond Street Hospital. 2002.

21.

Mars

Houston

W.J.B.

A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age. Cleft Palate J. 1990; 27: 7–10.

22.

Mars

James

D.R.

Lamabadusuriya

S.P.

The Sri Lankan Cleft Lip and Palate Project: the unoperated cleft lip and palate. Cleft Palate J. 1990; 27: 3–6.

23.

Mars

Plint

D.A.

Houston

W.J.

Bergland

Semb

The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate. Cleft Palate J. 1987; 24: 314–322.

24.

McCance

A.M.

Roberts-Harry

Sherriff

Mars

Houston

W.J.B.

A study model analysis of adult unoperated Sri Lankans with unilateral cleft lip and palate. Cleft Palate J. 1990; 27: 146–154.

25.

McComb

Primary correction of unilateral cleft lip nasal deformity: a 10-year review. Plast Reconstr Surg. 1985; 75: 791–799.

26.

Morris

D.O.

Roberts-Harry

Mars

Dental arch relationships in Yorkshire children with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2000; 37: 453–462.

27.

Murray

Hentges

Hill

Karpf

Mistry

Kreutz

Woodall

Moss

Goodacre

Cleft Lip and Palate Study Team. The effect of cleft lip and palate, and the timing of lip repair on mother-infant interactions and infant development. J Child Psychol Psychiatry. 2008; 49: 115–123.

28.

Nollet

P.J.

Katsaros

Van't Hof

M.A.

Kuijpers-Jagtman

A.M.

Treatment outcome in unilateral cleft lip and palate evaluated with the GOSLON yardstick: a meta-analysis of 1236 patients. Plast Reconstr Surg. 2005a; 116: 1255–1262.

29.

Nollet

PJPM

Katsaros

Van't Hof

M.A.

Semb

Shaw

W.C.

Kuijpers-Jagtman

A.M.

Treatment outcome after two-stage palatal closure in unilateral cleft lip and palate: a comparison with Eurocleft. Cleft Palate Craniofac J. 2005b; 42: 512–516.

30.

Noverraz

A.E.

Kuijpers-Jagtman

A.M.

Mars

van't Hof

M.A.

Timing of hard palate closure and dental arch relationships in unilateral cleft lip and palate patients: a mixed-longitudinal study. Cleft Palate Craniofac J. 1993; 30: 391–396.

31.

Rohrich

R.J.

Gosman

A.A.

An update on the timing of hard palate closure: a critical long-term analysis. Plast Reconstr Surg. 2004; 113: 350–352.

32.

Rohrich

R.J.

Love

E.J.

Byrd

H.S.

Johns

D.F.

Optimal timing of cleft palate closure. Plast Reconstr Surg. 2000; 106: 413–421.

33.

Ross

R.B.

Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Part 2: presurgical orthopaedics. Cleft Palate J. 1987a; 24: 24–32.

34.

Ross

R.B.

Treatment variables affecting facial growth in complete unilateral cleft lip and palate. Part 7: an overview of treatment and facial growth. Cleft Palate J. 1987b; 24: 70–77.

35.

Sandy

J.R.

Williams

A.C.

Bearn

Mildinhall

Murphy

Sell

Murray

J.J.

Shaw

W.C.

Cleft lip and palate care in the United Kingdom—the Clinical Standards Advisory Group (CSAG) Study. Part 1: background and methodology. Cleft Palate Craniofac J. 2001; 38: 20–23.

36.

Sell

Grunwell

Mildinhall

Murphy

Cornish

T.A.

Bearn

Shaw

W.C.

Murray

J.J.

Williams

A.C.

Sandy

J.R.

Cleft lip and palate care in the United Kingdom—the Clinical Standards Advisory Group (CSAG) Study. Part 3: speech outcomes [see comment]. Cleft Palate Craniofac J. 2001; 38: 30–37.

37.

Shaw

W.C.

Asher-McDade

Brattstrom

Dahl

McWilliam

Moisted

Plint

D.A.

Prahl-Andersen

Semb

The

R.P.

A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 1. Principles and study design. Cleft Palate Craniofac J. 1992a; 29: 393–397.

38.

Shaw

W.C.

Brattstrom

Moisted

Prahl-Andersen

Roberts

C.T.

Semb

The Eurocleft study: intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 5: discussion and conclusions. Cleft Palate Craniofac J. 2005; 42: 93–98.

39.

Shaw

W.C.

Dahl

Asher-McDade

Brattstrom

Mars

McWilliam

Moisted

Plint

D.A.

Prahl-Andersen

Roberts

. A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 5. General discussion and conclusions. Cleft Palate Craniofac J. 1992b; 29: 413–418.

40.

Sinko

Caacbay

Jagsch

Turhani

Baumann

Mars

The GOSLON yardstick in patients with unilateral cleft lip and palate: review of a Vienna sample. Cleft Palate Craniofac J. 2008; 45: 87–92.

41.

Stein

Dunsche

Gellrich

N.C.

Harle

Jonas

One- or two-stage palate closure in patients with unilateral cleft lip and palate: comparing cephalometric and occlusal outcomes. Cleft Palate Craniofac J. 2007; 44: 13–22.

42.

Susami

Ogihara

Matsuzaki

Sakiyama

Takato

Shaw

W.C.

Semb

Assessment of dental arch relationships in Japanese patients with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2006; 43: 96–102.

43.

Williams

A.C.

Bearn

Mildinhall

Murphy

Sell

Shaw

W.C.

Murray

J.J.

Sandy

J.R.

Cleft lip and palate care in the United Kingdom—the Clinical Standards Advisory Group (CSAG) Study. Part 2: dentofacial outcomes and patient satisfaction. [see comment]. Cleft Palate Craniofac J. 2001; 38: 24–29.

44.

Witt

P.D.

Marsh

J.L.

Advances in assessing outcome of surgical repair of cleft lip and cleft palate. Plast Reconstr Surg. 1997; 100: 1907–1917.

45.

Zreaqat

Hassan

Halim

A.S.

Dentoalveolar relationships of Malay children with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2009; 46: 326–330.