Intraoral Photographs for Rating Dental Arch Relationships in Unilateral Cleft Lip and Palate

Background and Purpose: The Goslon Yardstick is one of the most commonly used methods to assess dental arch relationships of patients with unilateral cleft lip and palate. This system was originally applied to dental casts. For reasons of economy and convenience, we aimed to determine whether intraoral photographs could substitute for dental casts for rating dental arch relationships. Methods: Records of 58 patients with nonsyndromic complete unilateral cleft lip and palate from the Chang Gung Craniofacial Center, Taipei, Taiwan, were used in this study. A set of dental casts and digital intraoral photographs taken at around 9 years of age were available for all patients. An experienced examiner rated the dental casts using the Goslon Yardstick to provide the reference scores. The other three examiners rated the intraoral photographs and repeated the rating 1 week later to calculate inter- and intraexaminer reliability. The photographic scores for each examiner were then compared with the reference scores to determine the validity of the photographs. Results: The results showed no significant difference between the rating of dental casts and photographs using the Goslon Yardstick. Reliability was also high for rating on photographs. Conclusions: Intraoral photographs appear to be a viable alternative to the application of the Goslon Yardstick on dental casts.

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Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: impact of maxillary dental agenesis on craniofacial growth and dental arch relationship in 8 year olds

European Journal of Orthodontics ◽

10.1093/ejo/cjab007 ◽

2021 ◽

Author(s):

Sara Rizell ◽

Annelise Küseler ◽

Arja Heliövaara ◽

Pål Skaare ◽

Eli Brinck ◽

...

Keyword(s):

Cleft Lip ◽

Randomized Trials ◽

Cleft Lip And Palate ◽

Dental Arch ◽

Craniofacial Growth ◽

Primary Surgery ◽

Maxillary Tooth ◽

Significant Difference ◽

The Impact ◽

Dental Arch Relationship

Summary Background It is suggested that dental agenesis affects maxillary protrusion and dental arch relationship in children with unilateral cleft lip and palate (UCLP). In addition, an association between the need for orthognathic surgery and dental agenesis is reported. Aim The aim was to study the impact of maxillary dental agenesis on craniofacial growth and dental arch relationship in 8-year-old children with UCLP. Subjects and methods The sample consisted of individuals with UCLP from Scandcleft randomized trials. The participants had available data from diagnosis of maxillary dental agenesis as well as cephalometric measurements (n = 399) and GOSLON assessment (n = 408) at 8 years of age. Results A statistically significant difference was found for ANB between individuals with agenesis of two or more maxillary teeth (mean 1.52°) in comparison with those with no or only one missing maxillary tooth (mean 3.30° and 2.70°, respectively). Mean NSL/NL was lower among individuals with agenesis of two or more maxillary teeth (mean 9.90°), in comparison with individuals with no or one missing maxillary tooth (mean 11.46° and 11.45°, respectively). The number of individuals with GOSLON score 4–5 was 47.2% in the group with two or more missing maxillary teeth and 26.1% respectively 26.3% in the groups with no or one missing maxillary tooth. No statistically significant difference was found in the comparison between individuals with no agenesis or with agenesis solely of the cleft-side lateral. Conclusion Maxillary dental agenesis impacts on craniofacial growth as well as dental arch relationship and should be considered in orthodontic treatment planning.

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The Influence of Orthodontic Treatment on the Goslon Score of Unilateral Cleft Lip and Palate Patients

The Cleft Palate-Craniofacial Journal ◽

10.1597/10-096 ◽

2012 ◽

Vol 49 (2) ◽

pp. 215-220 ◽

Cited By ~ 11

Author(s):

Peter Southall ◽

Mark Walters ◽

Steven Singer

Keyword(s):

Retrospective Study ◽

Treatment Group ◽

Surgical Outcome ◽

Orthodontic Treatment ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Favorable Outcome ◽

Dental Arch ◽

Significant Difference ◽

The Mean

Objective To assess the effect of orthodontic treatment on Goslon Yardstick outcome. Design Retrospective study. Patients A series of 66 consecutive patients born with a complete unilateral left lip and palate. Patients were sorted into a nontreatment group (n = 47) and a treatment group (n = 19). Method Three assessors trained in the use of the Goslon Yardstick ranked the dental arch relationships of study casts taken at 6 and 9 years. Results There was only a fair agreement (κ = .33) between 6- and 9-year Goslon Yardstick scores for the cohort of 66 patients, with a significant (p < .05) difference in the mean score at 6 years (3.17 ± 0.8) and at 9 years (2.88 ± 1.0). Removal of 19 subjects who had orthodontic inventions prior to taking of the 9-year-old study cast improved the agreement to moderate (κ = .52). There was no significant difference (p > .05) in mean scores at 6 and 9 years (3.13 ± 0.9 and 3.17 ± 1.03, respectively). The treatment group exhibited significant differences (p < .001) with mean Goslon Yardstick scores of 3.0 ± 0.9 at 6 and 2.25 ± 0.45 at 9 years. Conclusions The inclusion of patients who had received orthodontic treatment prior to taking of study casts being used for Goslon Yardstick scoring can result in a more favorable outcome. Patients who have received active orthodontic treatment prior to taking of dental casts should be excluded or accounted for in audits to assess primary cleft surgical outcome in patients with a unilateral cleft lip and palate.

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Changes in the Transverse Dimension of the Maxillary Arch of 5-Year-Olds Born With UCLP Since the Introduction of Nationwide Guidance

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211028511 ◽

2021 ◽

pp. 105566562110285

Author(s):

Charlotte Molyneaux ◽

Martyn Sherriff ◽

Yvonne Wren ◽

Anthony Ireland ◽

Jonathan Sandy

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Transverse Dimension ◽

Advisory Group ◽

Second Primary ◽

Primary Molar ◽

Cross Sectional ◽

Significant Difference ◽

Maxillary Arch ◽

Dental Casts

Objective: To determine whether the transverse dimensions of the maxillary arch of 5-year-old children with unilateral cleft lip and palate (UCLP) have changed following centralization of cleft services in the United Kingdom. Design: Retrospective cross-sectional study. Setting: Digital analysis of UCLP maxillary dental casts. Participants: All available maxillary dental casts from 5-year-old participants of the Clinical Standards Advisory Group (CSAG, N = 114) and Cleft Care UK (CCUK, N = 175) studies. Interventions: Quantitative measurements of the intercanine width (ICW), intermolar width (IMW), and the distance from the midline to the greater and lesser side canine (GC/LC) and greater side and lesser side second primary molar (GE/LE). Degree measurements of the greater and lesser arch form angles, arch length, anterior palatal depth (APD), and posterior palatal depth were also measured. Main outcome: Differences between the transverse dimensions of the maxillary arch for the CSAG and CCUK cohorts. Results: In 5 (ICW, IMW, LC, LE, and APD) of the 11 measurements, there was a statistically significant difference between the CSAG and CCUK cohorts. In all of these, the CCUK values were greater than CSAG. Conclusions: There have been small but positive improvements for the transverse maxillary dimensions since centralization of the UK cleft service.

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Evaluation of Maxillary Dental Arch Form in Unilateral Clefts of Lip, Alveolus, and Palate from One Month to Four Years

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1993_030_0090_eomdaf_2.3.co_2 ◽

1993 ◽

Vol 30 (1) ◽

pp. 90-93 ◽

Cited By ~ 8

Author(s):

M. Mazaheri ◽

A.E. Athanasiou ◽

R.E. Long ◽

O.G. Kolokitha

Keyword(s):

Soft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

The Other ◽

Dental Arch ◽

Early Age ◽

Arch Form ◽

The Relationship ◽

Vomer Flap ◽

Dental Arch Form

This study evaluated the early changes of maxillary alveolar arches of operated unilateral cleft lip and palate patients. Dental casts were available at four age increments. Triangular flap cheiloplasty was carried out at an early age. Two-stage palatoplasty by vomer flap and soft palate closure took place later. Prior to lip repair, the alveolar arches were classified according to the relationship between greater and lesser segments. Almost a quarter had overlap of the alveolar segments with no contact between the alveolar ridges at the cleft site; some had no overlap with contact of the alveolar segments in the cleft region; almost a quarter had both overlap of the alveolar segments and contact; and almost half had no overlap of the segments and the alveolar ridges were not in contact at the cleft site. After lip repair, the arch relationships were examined and the percentage of patients in each of the four groups indicated a moulding effect of lip repair on the alveolar segments. This moulding effect caused the alveolar segments in most patients to be in contact at the cleft site. Most of these also had segment overlap. All patients were re-examined shortly after palatal repair. The trend for segment overlap and contact continued after palate surgery. However, when all patients were seen at age 4, percentages of patients in each group indicated that previous overlap of segments improved to a more desirable nonoverlapped relationship in approximately half of the patients. The other half continued to demonstrate arch collapse, in excess of what would be considered ideal ridge relationship.

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Evaluation of the Effects of Cheiloplasty on Maxillary Arch in UCLP Infants Using Three-Dimensional Digital Models

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619835090 ◽

2019 ◽

Vol 56 (8) ◽

pp. 1013-1019 ◽

Cited By ~ 1

Author(s):

Thanawut Kongprasert ◽

Kengkart Winaikosol ◽

Araya Pisek ◽

Aggasit Manosudprasit ◽

Amornrut Manosudprasit ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

High Reliability ◽

Anterior Part ◽

Intraclass Correlation ◽

Dental Arch ◽

Posterior Arch ◽

Anterior Arch ◽

Arch Width ◽

Significant Difference

Objective: To analyze and identify changes in the maxillary dental arch before and after cheiloplasty in a group of unilateral complete cleft lip and palate (UCLP) infants. Design: This is a cohort study. Material and Method: Study models from 16 infants with nonsyndromic UCLP, who were treated at Khon Kaen University, were taken before (T1) and after cheiloplasty (T2). The dental models underwent a process of scanning through a 3D scanner, from which 9 linear and 2 angular landmarks were evaluated. Paired t test was used to compare the measurement statistically between T1 and T2. Results: Alveolar cleft gap (G-L), anterior basal angle (∠GC-CC′), and anterior arch curvature angle on greater segment (∠GIC) were significantly decreased ( P < .05). Contrarily, anterior ridge length of greater segment (C-I), anterior ridge length of lesser segment (L-C′), and posterior arch width (T-T′) were significantly increased ( P < .05) after cheiloplasty. While, anterior portion of greater segment (I-G), anterior arch width (C-C′), anterior arch depth (I⊥CC′), arch length (G⊥TT′), and arch circumference (T-C-I-G-L-C′-T′) showed no significant difference. The measurements were tested using the Intraclass correlation coefficient. The coefficients indicated high reliability. Conclusion: Cleft gap significantly decreased after lip repair, and the anterior part of maxillary dental arch was also bent palatally after cheiloplasty without any other intervention except cheiloplasty. More studies are needed to assess the amount of lip pressure. If any convincing force is presented, an appliance to prevent undesirable pressure is indicated.

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Prevalence of Hypodontia in Unilateral and Bilateral Cleft Lip and Palate Patients Inside and Outside Cleft Area: A Case-Control Study

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-43.2.10 ◽

2019 ◽

Vol 43 (2) ◽

pp. 126-130 ◽

Cited By ~ 4

Author(s):

Alberto De Stefani ◽

Giovanni Bruno ◽

Paolo Balasso ◽

Sergio Mazzoleni ◽

Ugo Baciliero ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Descriptive Analysis ◽

Control Sample ◽

Control Group ◽

Dental Arch ◽

Case Group ◽

Italian Population ◽

Control Groups ◽

Significant Difference

Objectives: The aim of this study is to evaluate the prevalence and distribution of hypodontia, inside and outside the cleft area, in an Italian population with a non-syndromic unilateral (UCLP) and bilateral (BCLP) cleft lip and palate on panoramic radiographs and comparing it with a control sample. Study design: Case group was ethnically uniform and consisted in 233 patients. The control group was composed of 1000 subjects. Patients included were between seven and fifteen years old. Descriptive analysis, using absolute and relative frequencies, was performed to check out the prevalence of gender distribution, hypodontia and cleft formation. Statistical analysis was conducted with Chi-squared test, Yate's correction and the Fisher's exact test. The power was set higher than 0.8 for each test. Results: 160 cleft patients (68.68%) presented at least one missing tooth, while 88 patients in the control groups presented agenesis (8.80%). A statistically significant difference was found in case and control groups for upper lateral incisors (37.34% and 48.07% in the case group against 2.50% and 2.60% in the control group), upper and lower second premolars (8.58%, 6.44%, 5.58% and 6.01% in the cleft group and 0.60%, 0.60%, 2.50% and 2.70% in the control group). Conclusion: Higher prevalence of dental agenesis in the maxillary dental arch is explained by the cleft defect. Higher prevalence of mandibular second premolars agenesis cannot be explained by the anatomical defect and suggests a multifactorial aetiology, including environmental and genetic factors, of the cleft condition.

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Photographs of Study Casts: An Alternative Medium for Rating Dental Arch Relationships in Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-101.1 ◽

2004 ◽

Vol 41 (6) ◽

pp. 646-650 ◽

Cited By ~ 26

Author(s):

Pieter J. P. M. Nollet ◽

Christos Katsaros ◽

Martin A. van 't Hof ◽

Catharina A. M. Bongaarts ◽

Gunvor Semb ◽

...

Keyword(s):

The Netherlands ◽

Repeated Measures ◽

Cleft Lip ◽

Outcome Measure ◽

Cleft Lip And Palate ◽

Medical Center ◽

Dental Arch ◽

Reproducible Method ◽

The University ◽

Dental Casts

Objective To investigate the reliability of using photographs of study casts as an alternative to casts for rating dental arch relationships. Design Repeated-measures study. Setting Cleft Palate Center of the University Medical Center Nijmegen, Nijmegen, The Netherlands. Patients Records of children with complete unilateral cleft lip and palate (UCLP) (n = 49) at the age of 9 years were included. Mean Outcome Measure(s) Statistics of intra- and interexaminer agreement. Results No significant differences were found between the rating of dental casts and photographs of dental casts, using the Goslon Yardstick. Conclusions Photographs of dental casts provide a consistent, reproducible method for rating dental arch relationships in patients with UCLP at the age of 9 years and provide a reliable alternative to the application of the Goslon Yardstick on dental casts.

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Facial profile and maxillary arch dimensions in unilateral cleft lip and palate children in the mixed dentition stage

European Journal of Dentistry ◽

10.4103/ejd.ejd_238_16 ◽

2017 ◽

Vol 11 (01) ◽

pp. 076-082 ◽

Cited By ~ 3

Author(s):

Vellore Kannan Gopinath ◽

Ab Rani Samsudin ◽

Siti Noor Fazliah Mohd Noor ◽

Hady Youssef Mohamed Sharab

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Cranial Base ◽

Mixed Dentition ◽

Dental Arch ◽

Base Length ◽

Facial Profile ◽

Arch Width ◽

Significant Difference ◽

Maxillary Arch

ABSTRACT Objectives: The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7–13 years). Materials and Methods: This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length. Results: Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001). Conclusion: Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

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