To evaluate the severity of the dental arch relationships and the treatment outcomes of reverse headgear (RHG) in southern Chinese patients with unilateral cleft lip and palate (UCLP).
Design:
A retrospective study.
Setting:
Faculty of Dentistry, The University of Hong Kong.
Patients:
Thirty-eight UCLP patients with complete records. Among them, 14 were later treated with RHG (RHG group) and 24 were under review (non-RHG group) before definitive orthodontic or in conjunction with orthognathic surgery.
Interventions:
Study models at T1 (aged 9.4 ± 0.4 years old), prebone grafting and before any orthodontic treatment started; T2 (aged 11.3 ± 0.6 years old), after bone grafting, and RHG treatment (RHG group) or under review (non-RHG group); and T3 (aged 15.3 ± 3.2 years old), pretreatment of definitive orthodontic or in conjunction with orthognathic surgery.
Main Outcome Measures:
With satisfactory intra- and interexaminer agreement proven by the kappa value, the dental arch relationships of the study models at T1, T2, and T3 were assessed by a solo calibrated examiner using the GOSLON Yardstick.
Results:
The median GOSLON score for southern Chinese patients with UCLP at T1 was 4.0. Sixty percent of the patients were categorized as “poor” at T1. RHG significantly improved dental arch relationships from T1 to T2, and the improvement was maintained until T3 assessed by the GOSLON Yardstick.
Conclusions:
The dental arch relationships in southern Chinese UCLP patients at 8 to 10 years old are unfavorable. RHG treatment shows positive effects in improving the dental arch relationships in UCLP patients, as assessed by the GOSLON Yardstick.
AltalibiM.SaltajiH.EdwardsR.MajorP.W.Flores-MirC.Indices to assess malocclusions in patients with cleft lip and palate.Eur J Orthod.2013; 35: 772–782.
2.
AltmanD.G.Practical Statistics for Medical Research.London: Chapman & Hall; 1991; 404–408.
3.
AtackN.E.HathornI.S.SembG.DowellT.SandyJ.R.A new index for assessing surgical outcome in unilateral cleft lip and palate subjects aged five: reproducibility and validity.Cleft Palate Craniofac J.1997; 34: 242–246.
4.
AthanasiouA.E.MazaheriM.ZarrinniaK.Dental arch dimensions in patients with unilateral cleft lip and palate.Cleft Palate J.1988; 25: 139–145.
5.
BartzelaT.LeenartsC.BronkhorstE.BorstlapW.KatsarosC.Kuijpers-JagtmanA.M.Comparison of two scoring systems for evaluation of treatment outcome in patients with complete bilateral cleft lip and palate.Cleft Palate Craniofac J.2011; 48: 455–461.
6.
BerglandO.SidhuS.S.Occlusal changes from the deciduous to the early mixed dentition in unilateral complete clefts.Cleft Palate J.1974; 11: 317–326.
7.
BerkowitzS.DuncanR.EvansC.FriedeH.Kuijpers-JagtmanA.M.Prahl-AndersonB.RosensteinS.Timing of cleft palate closure should be based on the ratio of the area of the cleft to that of the palatal segments and not on age alone.Plast Reconstr Surg.2005; 116: 361.
8.
BisharaS.E.KrauseC.J.OlinW.H.WestonD.Van NessJ.FellingC.Facial and dental relationships of individuals with unoperated clefts of the lip and/or palate.Cleft Palate J.1976; 13: 238–252.
9.
Borzabadi-FarahaniA.LanC.J.YenS.L.Late maxillary protraction in patients with unilateral cleft lip and palate: a retrospective study.Cleft Palate Craniofac J.2014; 51: e1–e10.
10.
ChenK.F.SoL.L.Y.Sagittal skeletal and dental changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate.The Angle Orthodontist.1996; 66(5): 363–372.
11.
ChenK.F.SoL.L.Y.Soft tissue profile changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate.ngle Orthod.1997; 67: 31–38.
12.
CobourneM.T.DiBiaseA.T.Handbook of Orthodontics.1st ed.Mosby: Elsevier; 2011; 376–388.
13.
da Silva FilhoO.G.de Castro MachadoF.M.de AndradeA.C.de Souza FreitasJ.A.BisharaS.E.Upper dental arch morphology of adult unoperated complete bilateral cleft lip and palate.Am J Orthod Dentofacial Orthop.1998; 114: 154–161.
14.
DelaireJ.VerdonP.KénésiM-CExtraoral Zugkräfte mit Stirn-Kinn-Abstützung zur Behandlung der Oberkieferdeformiefungenals Folge von Lippen-Kiefer-Gaumenspalten [in German].Fortschr Kieferorthop.1973; 34: 225–237.
15.
DobbynL.M.WeirJ.T.MacfarleneT.V.MosseyP.A.Calibration of the modified Huddart and Bodenham scoring system against the GOSLON/5-year-olds’ index for unilateral cleft lip and palate.Eur J Orthod.2012; 34: 762–767.
16.
GrayD.MosseyP.A.Evaluation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palateEur J Orthod.2005; 27: 507–511.
17.
GuY.RabieA.B.M.HäggU.Treatment effects of simple fixed appliance and reverse headgear in correction of anterior crossbite.Am J Orthod Dentofacial Orthop.2000; 116: 671–679.
18.
HäggU.TseA.BendeusM.RabieA.B.M.Long-term follow-up of early treatment with reverse headgear.Eur J Orthod.2003; 25: 95–102.
19.
HuddartA.G.BodenhamR.S.The evaluation of arch form and occlusion in unilateral cleft palate subjects.Cleft Palate J.1972; 9: 194–209.
20.
JiaH.LiW.LinJ.Maxillary protraction effects on anterior crossbites.Angle Orthod.2008; 78: 617–624.
KramerG.J.HoeksmaJ.B.Prahl-AndersenB.Early palatal changes after initial palatal surgery in children with cleft lip and palate.Cleft Palate Craniofac J.1996; 33: 104–111.
23.
LamS.V.BendeusM.WongW.K.A multidisciplinary team approach on cleft lip and palate management.Hong Kong Dental J.2007; 4: 38–45.
24.
LiaoY.F.LinI.F.Dental arch relationships after two-flap palatoplasty in Taiwanese patients with unilateral cleft lip and palate.Int J Oral Maxillofac Surg.2009; 38: 1133–1136.
25.
MarsM.Asher-McDadeC.BrattstromV.DahlE.McWilliamJ.MølstedK.PlintD.A.Prahl-AndersenB.SembG.ShawW.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.
26.
MarsM.BatraP.WorrellComplete unilateral cleft lip and palate: validity of the five-year index and the Goslon Yardstick in predicting long-term dental arch relationships.Cleft Palate Craniofac J.2006; 43: 557–562.
27.
MarsM.PlintD.A.HoustonW.J.B.BerglandO.SembG.The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate.Cleft Palate Craniofac J.1987; 24: 314–322.
28.
MølstedK.BrattstromV.Prahl-AndersenB.ShawW.C.SembG.The Eurocleft study: intercenter study of teatment outcome in patients with unilateral cleft lip and palate. Part 3: dental arch relationships.Cleft Palate Craniofac J.2005; 42: 78–82.
29.
MorrisD.Robert-HarryD.MarsM.Dental arch relationships in Yorkshire children with unilateral cleft lip and palate.Cleft Palate Craniofac J.2000; 37: 453–462.
30.
MosseyP.A.ClarkJ.D.GrayD.Preliminary investigation of a modified Huddart/Bodenham scoring system for assesment of maxillary arch constriction in unilateral cleft lip and palate subjects.Eur J Orthod.2003; 25: 251–257.
31.
NolletPJPMKatsarosC.Van't HofM.A.Kuijpers-JagtmanA.M.Treatment outcome in unilateral cleft lip and palate evaluated with the GOSLON Yardstick: a meta-analysis of 1236 patients.Plast Reconstr Surg.2005; 116: 1255–1262.
32.
NolletPJPMKatsarosC.Van't HofM.A.SembG.ShawW.C.Kuijpers-JagtmanA.M.Treatment outcome after two-stage palatal closure in unilateral cleft lip and palate: a comparison with eurocleft.Cleft Palate Craniofac J.2005; 42: 512–516.
33.
NoverrazA.E.Kuijpers-JagtmanA.M.MarsM.van't HofM.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.
PruzanskyS.AdussH.Prevalence of arch collapse and malocclusion in complete unilateral cleft lip and palate.Eur Orthod Soc Trans.1967; 43: 365–382.
36.
RantaR.Forward traction of the maxilla with cleft lip and palate in mixed and permanent dentitions.J Craniofac Surg.1989; 17(Suppl 1): 20–22.
37.
RantaR.Protraction of cleft maxilla.Eur J Orthod.1988; 10: 215–222.
38.
RossR.B.JohnstonM.C.Cleft Lip and Palate.Baltimore: Williams & Wilkins; 1972.
39.
SakudaM.Cleft lip and palate-with reference to craniofacial growth.J Jpn Orthod Soc.1978; 37: 139–160.
40.
SarnäsK-VRuneB.Extraoral traction to the maxilla with the facemask: a follow-up of 17 consecutively treated patients with and without cleft lip and palate.Cleft Palate J.1987; 24: 95–103.
41.
SoL.L.Y.Effects of reverse headgear treatment on sagittal correction in girls born with unilateral complete cleft lip and cleft palate - skeletal and dental changes.Am J Orthod Dentofacial Orthop.1996; 109: 140–147.
42.
StellzigA.BasdraE.K.HouserC.HassfeldS.KomposchG.Factors influencing changes in maxillary arch dimensions in unilateral cleft lip and palate patients until six months of age.Cleft Palate Craniofac J.1999; 36: 304–309.
43.
SusamiT.OgiharaY.MatsuzakiM.SakiyamaM.TakatoT.ShawWC.SembG.Assessment of dental arch relationships in Japanese patients with unilateral cleft lip and palate.Cleft Palate Craniofac J.2006; 43: 96–102.
44.
TindlundR.S.Orthopaedic protraction of the midface in the deciduous dentition-results covering 3 years out of treatment.J Craniomaxillofac Surg.1989; 17: 17–19.
45.
TindlundR.S.RydhP.Maxillary protraction: different effects on facial morphology in unilateral and bilateral cleft lip and palate patients.Cleft Palate Craniofac J.1993; 30: 208–221.
46.
TindlundR.S.RyghP.BøeO.E.Orthopeadic protraction of the upper jaw in cleft lip and palate patients during the decidous and mixed dentition periods in comparison with normal growth and development.Cleft Palate Craniofac J.1993; 30: 182–194.
47.
TothillC.MosseyP.A.Assessment of arch constriction in patients with bilateral cleft lip and palate and isolated cleft palate: a pilot study.Eur J Orthod.2007; 29: 193–197.
ZhuS.YangY.GuM.KhambayB.A comparison of three eviewing media for assessing dental arch relationships in patients with unilateral cleft lip and palate.Cleft Palate Craniofac J.2016; 53: 578–583.
50.
ZreaqatM.HassanR.HalimA.S.Dentoalveolar relationships of Malay children with unilateral cleft lip and palate.Cleft Palate Craniofac J.2009; 46: 326–330.
