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

2006 ◽  
Vol 43 (5) ◽  
pp. 606-611 ◽  
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.

Assessment of Dental Arch Relationships in Japanese Patients with Unilateral Cleft Lip and Palate

2006 ◽  
Vol 43 (1) ◽  
pp. 96-102 ◽  
Author(s):  
Takafumi Susami ◽  
Yuji Ogihara ◽  
Masako Matsuzaki ◽  
Miyuki Sakiyama ◽  
Tsuyoshi Takato ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Good Practice ◽  
Weighted Kappa ◽  
Japanese Patients ◽  
Craniofacial Morphology ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Consecutive Series ◽  
Alveolar Bone Grafting

Objective Evaluation of the dental arch relationships of Japanese patients with unilateral cleft lip and palate (UCLP) from the orthodontic clinic of the University of Tokyo Hospital (UTH) compared with patients treated by the Oslo Cleft Team, Norway. Design Retrospective study and comparison with previous reports. Materials Dental models of 24 patients with UCLP in UTH taken before orthodontic treatment and before alveolar bone grafting were included. Surgeons in many hospitals performed primary surgeries. These models were matched for age and gender with 24 models from a consecutive series of patients treated by the Oslo Cleft Team as part of the Eurocran Good Practice Archive. A total of 48 models were evaluated. Main Outcome Measure Dental arch relationship was rated with the Goslon Yardstick. The strength of agreement of rating was assessed with weighted kappa statistics. Results Intra- and interexaminer agreements evaluated by weighted kappa statistics were high, indicating good reproducibility. Almost 60% of the patients in UTH were classified into poor or very poor categories, and the mean Goslon score was 3.50. These results show a contrast to those in Oslo and were the poorest in comparison with previous reports. Conclusion Dental arch relationships in patients with UCLP in UTH were poor. This seemed to be attributable to surgical procedures, but a factor of racial difference in the craniofacial morphology was also considered. Further intercenter research is required to clarify this point.

Dental Arch Relationship in Children with Complete Unilateral Cleft Lip and Palate following Warsaw (One-Stage Repair) and Oslo Protocols

2009 ◽  
Vol 46 (6) ◽  
pp. 648-653 ◽  
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Zofia Dudkiewicz ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Weighted Kappa ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Consecutive Series ◽  
One Stage ◽  
Mother And Child ◽  
The Difference ◽  
Dental Arch Relationship

Objective: To compare the dental arch relationship following one-stage repair of unilateral cleft lip and palate (UCLP) in Warsaw with a matched sample of patients treated by the Oslo Cleft Team. Material: Study models of 61 children (mean age, 11.2; SD, 1.7) with a nonsyndromic complete UCLP consecutively treated with one-stage closure of the cleft at 9.2 months (range, 6.0 to 15.8 months; SD, 2.0) by the Warsaw Cleft Team at the Institute of Mother and Child, Poland, were compared with a sample drawn from a consecutive series of patients with UCLP treated by the Oslo Cleft Team and matched for age, gender, and soft tissue band. Methods: The study models were given random numbers to blind their origin. Four examiners rated the dental arch relationship using the GOSLON Yardstick. The strength of agreement of rating was assessed with weighted Kappa statistics. An independent t-test was carried out to compare the GOSLON scores between Warsaw and Oslo samples, and Fisher's exact tests were performed to evaluate the difference of distribution of the GOSLON scores. Results: The intrarater and interrater agreements were high (K ≥ .800). No difference in dental arch relationship between Warsaw and Oslo groups was found (mean GOSLON score  =  2.68 and 2.65 for Warsaw and Oslo samples, respectively). The distribution of the GOSLON grades was similar in both groups. Conclusions: The dental arch relationship following one-stage repair (Warsaw protocol) was comparable with the outcome of the Oslo Cleft Team's protocol.

Complete Unilateral Cleft Lip and Palate: Validity of the Five-Year Index and the Goslon Yardstick in Predicting Long-Term Dental Arch Relationships

2006 ◽  
Vol 43 (5) ◽  
pp. 557-562 ◽  
Author(s):  
Michael Mars ◽  
Puneet Batra ◽  
Emma Worrell
Keyword(s):  
Retrospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Weighted Kappa ◽  
University Hospital ◽  
Dental Arch ◽  
Kappa Score

Objective: To assess the validity of the 5-year index by subjecting study models at the age of 5 years to both the 5-year index and the Goslon yardstick, and then relating these results to the Goslon ratings at 10 years. Design: Retrospective study. Setting: Sahlgrenska University Hospital, Gothenburg, Sweden. Patients: Study models of 94 patients with unilateral cleft lip and palate (UCLP) were evaluated at the ages of 5 and 10 years. The dental arch relationships were judged and categorized by using the Goslon yardstick for the 10-year models and both the Goslon yardstick and the 5-year index for the 5-year models. Results: When used for 5- and 10-year models, the Goslon yardstick showed a kappa score of 0.539 (weighted kappa = 0.579) with a moderate strength of agreement. However, 5-year index scores at 5 years compared with the Goslon scores at 10 years showed a kappa score of only 0.043 (weighted kappa = 0.090), showing poor strength of agreement. Goslon scores at 10 years showed improvement in 14 cases when graded by the same Goslon yardstick at 5 years, whereas there was improvement in 23 cases when the 5-year models were graded by the 5-year index (actual improvement in scores in UCLP cases is highly unlikely). Conclusions: Although use of the Goslon yardstick at 5 years has demonstrated some inherent flaws in its use at that age, these drawbacks are fewer than those when the 5-year index is used at 5 years of age.

Dentoalveolar Relationships of Malay Children with Unilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Ma'en Zreaqat ◽  
Rozita Hassan ◽  
Ahmad Sukari Halim
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Medical Science ◽  
Weighted Kappa ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Sample Population ◽  
Grade 5 ◽  
Grade 3

Objective: To determine the treatment outcome based on dentoalveolar relationships among Malay children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). Design: Retrospective cohort study. Setting and Sample Population: The Department of Orthodontics at the School of Dental Science and the Reconstructive Sciences Unit, School of Medical Science, Universiti Sains Malaysia. Dental study models of 82 UCLP Malay children aged 8 to 10 years were evaluated. All subjects had their cleft lip and palate repaired, but no alveolar bone graft or any orthodontic treatment was performed. Outcome Measure: The outcome of dental arch relationships was assessed using the Goslon Yardstick Index: a dental measure with outcomes ranked on a scale ranging from 1 to 5. Agreement of rating was assessed with weighted kappa statistics; both intraexaminer and interexaminer agreements were high, indicating good reproducibility. Results: A total of 2.4% of the sample was in grade 1, 24.4% in grade 2, 35.4% in grade 3, 31.7% in grade 4, and 6.1% in grade 5. The mean Goslon index score was 3.15. Conclusion: Dentoalveolar relationship outcomes of UCLP Malay children are intermediate according to the Goslon Yardstick. Interpretation of results should consider the ethnic differences in the craniofacial complex.

scholarly journals Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

2012 ◽  
Vol 49 (2) ◽  
pp. 230-236 ◽  
Author(s):  
Muhammad Syafrudin Hak ◽  
Masaaki Sasaguri ◽  
Farida Kamil Sulaiman ◽  
Enny Tyasandarwati Hardono ◽  
Akira Suzuki ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Bilateral Cleft Lip ◽  
Maxillary Growth ◽  
Prospective Longitudinal

Objective To investigate the effects of infant orthopedic treatment and lip adhesion on maxillary growth of patients with bilateral cleft lip and palate (BCLP). Design Prospective longitudinal study. Setting The present study was conducted at the Cleft Lip and Palate Center, Harapan Kita Children and Maternity Hospital, Indonesia, and the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Japan. Subjects The study sample consisted of 53 patients with complete BCLP and 10 noncleft patients with other diseases. Patients with BCLP were divided into three groups: H (-), 11 patients treated without Hotz's plate; H (+), 24 treated with Hotz's plate; and LA-H, 18 treated with lip adhesion and Hotz's plate. Methods Serial dental casts were obtained from each BCLP child at the following four time points: first visit, labioplasty, palatoplasty, and 5 years of age. Each maxillary dental cast was scanned, and the linear and angular dimensions were measured. Results and Conclusion Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

Midfacial Growth in a Consecutive Series of Preadolescent Children with Complete Unilateral Cleft Lip and Palate following a One-Stage Simultaneous Repair

2008 ◽  
Vol 45 (6) ◽  
pp. 667-673 ◽  
Author(s):  
Piotr Fudalej ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Anna Samarcew-Krawczak ◽  
Zofia Dudkiewicz
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Consecutive Series ◽  
Age And Gender ◽  
Prepubertal Children ◽  
One Stage ◽  
Lateral Cephalograms ◽  
And Gender ◽  
Posterior Position

Objective: To evaluate midfacial growth in prepubertal children with complete unilateral cleft lip and palate following one-stage simultaneous repair. Subjects: A series of 28 consecutively treated subjects with complete unilateral cleft lip and palate were compared with age- and gender-matched controls with normal midfacial structure. Methods: On the lateral cephalograms taken at the age of approximately 10 years, size and position of the maxilla and upper dental arch were evaluated in vertical and horizontal planes. Statistical analysis included independent t tests and nonparametric Mann-Whitney tests. Results: The maxilla was found to be retruded (sella-nasion-point A angle decreased by 4.5° and nasion to point A distance increased by 4.2 mm) and rotated posteriorly (sella-nasion/palatal plane angle decreased by 4.5°) in the cleft group. Maxillary length (pterygomaxillare-point A distance) was diminished by approximately 2 mm. Upper incisors were found retroclined in comparison to controls (both upper incisor axis/sella-nasion and upper incisor axis/palatal plane angles were decreased by 10.7° and 6.1°, respectively). Conclusion: Maxillary prominence, as measured with the sella-nasion-point A angle and the condylion-point A and articulare-point A distances, was decreased. Shortened length and posterior position of the maxillary body were responsible at a ratio of 60% to 40% for a decreased prominence of the maxillary complex. The palatal plane demonstrated a larger inclination to the sella-nasion plane by 4.5° due to a decreased sella-posterior nasal spine distance.

Problems With Reliability of Speech Variables for Use in Quality Registries for Cleft Lip and Palate—Experiences From the Swedish Cleft Lip and Palate Registry

2018 ◽  
Vol 55 (8) ◽  
pp. 1051-1059 ◽  
Author(s):  
Jan-Olof Malmborn ◽  
Magnus Becker ◽  
Kristina Klintö
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Intraclass Correlation ◽  
Weighted Kappa ◽  
University Hospital ◽  
Percentage Agreement ◽  
Quality Registry ◽  
Audio Recordings ◽  
Absolute Agreement ◽  
Velopharyngeal Function

Objective: To test the reliability of the speech data in the Swedish quality registry for cleft lip and palate. Design: Retrospective study. Setting: Primary care university hospital. Participants: Ninety-four children born with cleft palate with or without cleft lip between 2005 and 2009 who had been assessed and registered in the quality registry at the age of 5 years. Main Outcome Measures: Data in the registry on percent oral consonants correct, percent oral errors, percent nonoral errors, perceived velopharyngeal function (PVPF), and intelligibility were compared with results based on reassessments by 3 independent raters from audio recordings. Agreement was calculated by the intraclass correlation coefficient (ICC), quadratic weighted kappa, and percentage agreement. Results: Absolute agreement calculated by average measures ICC for percent oral consonants correct, percent oral errors, and percent nonoral errors was above >0.90. Single measures ICC for percent oral consonants correct was 0.82, for percent oral errors 0.69, and for percent nonoral errors 0.83. The kappa coefficient for PVPF was 0.5 to 0.59 and for intelligibility 0.65 to 0.77. Exact percentage agreement for PVPF was 33% and for intelligibility 47.8%. Conclusions: The data on oral consonants correct and nonoral errors in the quality registry seem to be reliable. The data on oral errors, PVPF, and intelligibility should be interpreted with caution. If differences among treatment centers are detected, one should go back and examine the collected raw data before drawing any definitive conclusions about treatment outcome.

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

1993 ◽  
Vol 30 (4) ◽  
pp. 391-396 ◽  
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 ◽  
Mixed Dentition ◽  
Dental Development ◽  
Dental Arch ◽  
Group A ◽  
Group B ◽  
Group D

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.

Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology?

2014 ◽  
Vol 51 (6) ◽  
pp. 696-706 ◽  
Author(s):  
Akira Suzuki ◽  
Masaaki Sasaguri ◽  
Kenji Hiura ◽  
Atsushi Yasunaga ◽  
Takeshi Mitsuyasu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Order ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Lateral Cephalograms ◽  
Prospective Longitudinal ◽  
The Relationship ◽  
Dental Cast

Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

Use of Bauru Yardstick in Patients With Complete Bilateral Cleft Lip and Palate at an Indian Center

2017 ◽  
Vol 55 (4) ◽  
pp. 602-606
Author(s):  
Puneet Batra ◽  
Gopala Krishna Annavarapv ◽  
Ashish Chopra ◽  
Amit Srivastava ◽  
Partha Sadhu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Weighted Kappa ◽  
Dental Arch ◽  
Age Group ◽  
Bilateral Cleft Lip ◽  
Examiner Agreement ◽  
Dental Cast ◽  
Dental Arch Relationship ◽  
Very High

Objective: To evaluate dental arch relationship in treated bilateral cleft lip and palate (BCLP) cases at an Indian cleft center using the Bauru yardstick. Patients and methods: Digital photographs of the dental cast of 50 consecutively treated patients (28 males and 22 females) with nonsyndromic BCLP at an Indian cleft center were rated by 2 examiners as per the Bauru yardstick for the 12-year-old age group. The average age group was 12 ± 0.62 years. All cases were treated with same surgical protocol. Results: The inter-examiner agreement between the 3 examiners was found to be very high, with weighted kappa values ranging from 0.894 to 0.951. The intraexaminer agreement between the 2 examinations for all the examiners was also found to be very high, with weighted kappa values ranging from 0.894 to 0.931. Seventy-eight percent of patients were rated with a Bauru yardstick score of 1+2. In addition, 10% of patients were rated with a score of 3, 8% as 4, and 4% as 5. The overall Bauru yardstick score for the center was 2.36. Conclusion: The protocol followed for the repair of BCLP cases by the center was found to be a good regimen in regard to the Bauru yardstick score.

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