Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair

In a mixed longitudinal study, dental arch relationships of 88 consecutive UCLP patients treated at the Nijmegen Cleft Palate Centre were evaluated using the Goslon Yardstick. On the basis of timing of hard palate closure, the patients were divided into four groups. Mean age of hard palate closure in group A (n = 18) was 1.5 years, in group B (n = 26) 4.6 years and in group C (n = 18) 9.4 years. In group D (n = 26, no patient older than 10 years) the hard palate was still open. Four stages of dental development were distinguished; deciduous dentition, early mixed dentition, late mixed dentition and permanent dentition. Reproducibility of scoring with the Goslon Yardstick was good for all stages of dental development. No differences in dental arch relationships were found between the four groups. In 86% of the cases, the dental arch relationships of UCLP patients treated in Nijmegen were acceptable. Pharyngeal flap surgery had minor unfavorable effects on dental arch relationships.

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Timing of hard palate closure and dental arch relationships in unilateral cleft lip and palate patients: a mixed-longitudinal study

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/0266-4356(94)90192-9 ◽

1994 ◽

Vol 32 (1) ◽

pp. 59

Author(s):

W.P. Smith

Keyword(s):

Longitudinal Study ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Dental Arch

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Analysis of Dental Arch Relationships in Swedish Unilateral Cleft Lip and Palate Subjects: 20-Year Longitudinal Consecutive Series Treated with Delayed Hard Palate Closure

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-069 ◽

2006 ◽

Vol 43 (5) ◽

pp. 606-611 ◽

Cited By ~ 65

Author(s):

Jan Lilja ◽

Michael Mars ◽

Anna Elander ◽

Lars Enocson ◽

Catharina Hagberg ◽

...

Keyword(s):

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Weighted Kappa ◽

University Hospital ◽

Dental Arch ◽

Study Cohort ◽

Kappa Statistics ◽

Consecutive Series ◽

Group 5

Objective: To evaluate the dental arch relationships for a consecutive series from Goteborg, Sweden, who had delayed hard palate closure. Design: Retrospective study. Setting: Sahlgrenska University Hospital, Goteborg, Sweden. Patients: The dental study models of 104 consecutive unilateral cleft lip and palate subjects. The study cohort was born between 1979 and 1994. Longitudinal records were available at ages 5 (n = 94), 10 (n = 97), 16 (n = 59), and 19 years (n = 46). Five assessors rated models according to the GOSLON Yardstick on two separate occasions each. Interventions: These patients had been operated upon according to the Goteborg protocol of delayed hard palate closure (at age 8 years). Results: 85% of subjects were rated in groups 1 and 2 (excellent or very good outcome), 12% were rated in group 3 (satisfactory), and 3% were assigned to group 4 (poor). No patients presented in Group 5 (very poor). Weighted kappa statistics for double determination of Yardstick allocation for five assessors demonstrated values between .65 and .90 for interrater agreement (good/very good) and between .70 and .90 for intrarater agreement (very good). Conclusions: Delayed hard palate closure as practiced in Goteborg since 1979 has produced the best GOSLON Yardstick ratings in a consecutive series of patients ever recorded worldwide, since the Yardstick was first used in 1983. However, it is noteworthy that a new protocol has been introduced in Goteborg since 1994, in which hard palate closure is done at 3 years due to concerns regarding speech.

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Timing of Hard Palate Closure and Dental Arch Relationships in Unilateral Cleft Lip and Palate Patients: A Mixed-Longitudinal Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569(1993)030<0391:tohpca>2.3.co;2 ◽

1993 ◽

Vol 30 (4) ◽

pp. 391-396 ◽

Cited By ~ 50

Author(s):

Alexis E. M. Noverraz ◽

Anne Marie Kuijpers-Jagtman ◽

Michael Mars ◽

Martin A. van't Hof

Keyword(s):

Longitudinal Study ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Dental Arch

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Dental Arch Relationship Outcomes Following 2-Stage Palatoplasty for Japanese Patients With Complete Unilateral Cleft Lip and Palate: A 3-Center Study

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211010606 ◽

2021 ◽

pp. 105566562110106

Author(s):

Junya Kato ◽

Tadashi Mikoya ◽

Yumi Ito ◽

Yoshiaki Sato ◽

Setsuko Uematsu ◽

...

Keyword(s):

Soft Palate ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Japanese Patients ◽

Dental Arch ◽

Perfect Agreement ◽

Cross Sectional ◽

Relationship Outcomes ◽

Dental Arch Relationship

Objective: To compare dental arch relationship outcomes following 3 different 2-stage palatal repair protocols. Design: Retrospective, cross sectional. Setting: Three cleft palate centers (A, B, C) in Japan. Patients: Ninety (A: 39, B: 26, C: 25) consecutively treated Japanese patients with complete unilateral cleft lip and palate. Interventions: In A, the soft palate and the posterior half of the hard palate were repaired at a mean age of 1 year 7 months. In B, the soft palate and hard palate were closed separately at a mean age of 1 year 6 months and 5 years 8 months, respectively. In C, the soft palate and hard palate were closed at a mean age of 1 year and 1 year 5 months, respectively. Main Outcome Measures: Dental arch relationships were assessed using the 5-Year-Olds’ (5-Y) index by 5 raters and the Huddart/Bodenham (HB) index by 2 raters. Results: Intra- and inter-rater reliabilities showed substantial or almost perfect agreement for the 5-Y and HB ratings. No significant differences in mean values and distributions of 5-Y scores were found among the 3 centers. The mean HB index scores of molars on the minor segment were significantly smaller in C than those in A and B ( P < .05). Conclusions: There were no significant differences in dental arch relationships at 5 years among the times and techniques of hard palate closure. However, further analysis of the possible influence of infant cleft size as a covariable on a larger sample size is needed.

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