Treatment Outcome of Bangladeshi UCLP Patients Based on Both Phenotype and Postnatal Treatment Factors using Modified Huddart Bodenham (mHB) Index

2018 ◽  
Vol 55 (7) ◽  
pp. 966-973 ◽  
Author(s):  
Sanjida Haque ◽  
Mohammad Khursheed Alam ◽  
Mohd Fadhli Khamis
Keyword(s):  
Regression Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Class Iii ◽  
Chi Square ◽  
Positive History ◽  
Postnatal Treatment ◽  
History Of

Objective: To evaluate the dental arch relationship (DAR) of nonsyndromic unilateral cleft lip and palate (UCLP) and to explore the various phenotype and postnatal treatment factors that are responsible for poor DAR. Design: Retrospective study. Setting: School of Dental Science, Universiti Sains Malaysia. Subjects: Eighty-four Bangladeshi children with nonsyndromic UCLP who received cheiloplasty and palatoplasty. Main Outcome Measures: Dental models were taken at 5 to 12 years of age (man: 7.69), and dental arch relationships were assessed using modified Huddart/Bodenham index (mHB) by two raters. Kappa statistics was used to evaluate the intra- and interexaminer agreements, chi-square was used to assess the associations, and logistic regression analysis was used to explore the responsible factors that affect DAR. Results: The total mHB score (mean [SD]) was −8.261 (7.115). Intra- and interagreement was very good. Using crude and stepwise backward regression analysis, significant association was found between positive history of class III (P = .025, P = .030, respectively) and unfavorable DAR. Complete UCLP (P = .003) was also significantly correlated with unfavorable DAR. Conclusion: This multivariate study suggested complete type of UCLP and positive history of class III had a significantly unfavorable effect on the DAR.

Factors Responsible for Unfavorable Dental Arch Relationship in non Syndromic Unilateral Cleft Lip and Palate Children

2017 ◽  
Vol 41 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Sanjida Haque ◽  
Mohammad Khursheed Alam ◽  
Mohd Fadhli Khamis
Keyword(s):  
Regression Analysis ◽  
Family History ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Class Iii ◽  
Skeletal Class ◽  
History Of ◽  
Relationship Of ◽  
Dental Arch Relationship

Objectives: Multiple factors are whispered to be crucial cause of unfavourable dental arch relationship in cleft lip and palate (CLP).This study aims to evaluate the dental arch relationship of Bangladeshi children with non syndromic unilateral cleft lip and palate (UCLP) following cheiloplasty and palatoplasty. Also to explore the various congenital (UCLP type, UCLP side, family history of cleft, family history of class III) and environmental (cheiloplasty, palatoplasty) factors that affects dental arch relationship of UCLP patients. Study design: This was a retrospective study where 84 dental models were taken before orthodontic treatment and alveolar bone grafting. The mean age was 7.69± 2.46 (mean± SD). The dental arch relationship was assessed by GOSLON (Great Ormond Street, London and Oslo) Yardstick. According to GOSLON Yardstick, five categories are rated; named- 1: excellent; 2: good; 3: fair; 4: poor; 5: very poor. Also the groups have been dichotomized into favorable (category ratings 1–3) and unfavorable (category ratings 4 and 5) groups. Kappa statistics was used to evaluate the intra- and inter-examiner agreements and logistic regression analysis was used to explore the responsible factors that affect dental arch relationship. Results: Total 37 subjects (44% of all subjects) were categorized into unfavourable group (category rating 4 and 5) using GOSLON yardstick. Intra- and inter-examiner agreements were very good. The mean GOSLON score was 3.238. Using crude and stepwise backward regression analysis, significant association was found between family history of skeletal class III malocclusion (p = 0.015 and p = 0.014 respectively) and unfavourable dental arch relationship. Complete UCLP (p = 0.054) and left sided UCLP (p = 0.053) also seemed to be correlated but not significant with unfavourable dental arch relationship using crude and stepwise backward regression analysis respectively. Conclusion: This analysis suggested that family history of skeletal class III was significantly correlated with unfavourable dental arch relationship of Bangladeshi UCLP children.

scholarly journals The Assessment of 3D Digital Models Using GOSLON Yardstick Index: Exploring Confounding Factors Responsible for Unfavourable Treatment Outcome in Multi-Population Children With UCLP

2021 ◽  
Vol 9 ◽  
Author(s):  
Sanjida Haque ◽  
Mohd Fadhli Khamis ◽  
Mohammad Khursheed Alam ◽  
Amir Wan Muhamad Wan Ahmad
Keyword(s):  
Family History ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Class Iii ◽  
Digital Models ◽  
History Of ◽  
Bangladeshi Population ◽  
3D Digital Models

To evaluate dental arch relationship (DAR) using GOSLON Yardstick and also to explore the association between multiple factors (age, gender, UCLP types, UCLP side, Family history of cleft, family history of Class III malocclusion, techniques of cheiloplasty, techniques of palatoplasty) and DAR in children unilateral cleft lip and palate (UCLP) in different populations. Two hundred fifty-five laser scanned 3D digital models (LS3DM) of UCLP children (5–12 years) from Malaysia, Bangladesh, and Pakistan were included. The intra- and inter-examiner agreements were evaluated by kappa statistics, to compare the GOSLON mean score between the populations and to explore the responsible factors that affect DAR, one way ANOVA, and crude logistic regression analysis was used, respectively. The mean GOSLON score was 2.97; 3.40 and 3.09 in Malaysia, Bangladesh, and Pakistan, respectively. Twenty seven, 40, and 30 subjects were in unfavourable (category rating 4 and 5) groups in Malaysia, Bangladesh, and Pakistan, respectively. A significant association was found between techniques of palatoplasty (p = 0.03; p = 0.04 and p = 0.04 in Malaysia, Bangladesh, and Pakistan, respectively) and unfavourable DAR. Different cheiloplasty techniques (p = 0.04) and gender (p = 0.03) also exhibited noteworthy associations with unfavourable DAR in the Bangladeshi population. Bardach techniques of palatoplasty were significantly associated with unfavourable DAR in all three populations. Moreover, male UCLP and modified Millard techniques of cheiloplasty were also associated with unfavourable DAR in the Bangladeshi population.

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.

Dentoalveolar Cleft Treatment Outcome Using Modified Huddart-Bodenham Index and Regression Analysis of Associated Factors

2018 ◽  
Vol 55 (5) ◽  
pp. 682-687 ◽  
Author(s):  
Anas Imran Arshad ◽  
Mohammad Khursheed Alam ◽  
Mohammad Fadhli Khamis
Keyword(s):  
Treatment Outcome ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Total Occlusion ◽  
Final Model ◽  
History Of ◽  
Permanent Molars ◽  
Dental Models ◽  
Postnatal Factors

Objectives: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome. Design: Retrospective observational study. Setting: Two regional cleft-referral centers. Main Outcome Measures: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score. Results: According to MHB, a mean (standard deviation) total occlusion score of –8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables—gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty—were analyzed with a logistic regression model. Conclusions: Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.

A Multicenter Outcomes Assessment of Five-Year-Old Patients with Unilateral Cleft Lip and Palate

2006 ◽  
Vol 43 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Wanda Flinn ◽  
Ross E. Long ◽  
Giovanna Garattini ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Primary Repair ◽  
Dental Arch ◽  
University Hospitals ◽  
Free Standing ◽  
Chi Square ◽  
Old Patients ◽  
Palate Repair ◽  
Presurgical Orthopedics

Objective Compare 5-year-old dental arch relationships of patients from three centers with differing primary protocols. Design Retrospective study of treatment outcomes using blinded evaluation of dental study casts. Setting Three major cleft-craniofacial centers; one (center A) is a free-standing institution, and two (centers B and C) are university hospitals. Patients 118 (A = 41; B = 33; C = 44) consecutively treated 5-year-old patients with complete, nonsyndromic unilateral cleft lip and palate. Interventions Centers A and C completed primary repair without presurgical orthopedics by 18 months (center A in three surgeries and center C in two surgeries). Center B used passive presurgical orthopedics with lip/soft palate repair at 6 months and gingivo-alveoloplasty/hard palate repair at 18 to 36 months. Main Outcome Measure Averaged ratings of dental casts using the 5-year yardstick were computed for each patient. The Wilcoxon two-sample test was used to compare means; a chi-square test was used to compare distributions. Results Intra- and interexaminer reliability tests showed excellent reliability (>.90). Mean scores were not significantly different. Distribution of scores differed significantly. Center A had the highest percentage of good scores and the lowest percentage of poor scores (72% versus 6.5%), followed by center B (63% versus 6.6%) and center C (59% versus 16.3%). Conclusions Centers A and B had comparable scores and completely different protocols in surgical technique, timing, sequencing, and nonuse/use of appliances. Center C's results were slightly lower than those of 1 and 3, but the center had the protocol with the least burden of treatment (only two surgeries, without use of appliances).

Treatment Outcome after One-Stage Repair in Children with Complete Unilateral Cleft Lip and Palate Assessed with the Goslon Yardstick

2009 ◽  
Vol 46 (4) ◽  
pp. 374-380 ◽  
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Zofia Dudkiewicz ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Interrater Agreement ◽  
Dental Arch ◽  
First Year ◽  
Kappa Statistics ◽  
One Stage ◽  
First Year Of Life ◽  
Plaster Models

Objective: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. Materials and Methods: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and palate (UCLP) that was repaired with a one-stage simultaneous closure performed in the first year of life. All individuals were born between 1994 and 1995. The Goslon score (categories 1 to 5) was allocated. Intra- and interrater agreement was assessed with kappa statistics and Pearson correlation coefficient. Independent t tests were employed to detect difference between the score in the present and other published samples. Results: Mean Goslon score equaled 2.44; 57% of the patients were allocated Goslon category 1 or 2, 32% were rated Goslon 3, and 11% of the patients were assigned category 4 or 5. Intrarater agreement was between 0.75 and 0.77. Interrater agreement was 0.79. Conclusions: Dental arch relationship following one-stage repair was comparable with the results of the centers with the best outcome.

scholarly journals Incisor and molar overjet, arch contraction, and molar relationship in the mixed dentition in repaired complete unilateral cleft lip and palate: A qualitative and quantitative appraisal

2017 ◽  
Vol 87 (4) ◽  
pp. 603-609 ◽  
Author(s):  
Suteeta Disthaporn ◽  
Sunjay Suri ◽  
Bruce Ross ◽  
Bryan Tompson ◽  
Diogenes Baena ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Class Ii ◽  
Mixed Dentition ◽  
Dental Arch ◽  
Kappa Statistics ◽  
Permanent Molar ◽  
Alveolar Bone Grafting ◽  
The Difference

ABSTRACT Objective: To compare the mixed dentition incisor and molar overjet, severity of contraction of the dental arch, and the sagittal molar relationship on the cleft side vs the noncleft side in children with repaired complete unilateral cleft of the lip and palate (UCLP). Materials and Methods: Orthodontic records taken prior to orthodontic preparation for alveolar bone grafting were screened to select study casts from patients with nonsyndromic repaired complete UCLP who did not have mandibular skeletal or dental asymmetry. The study sample comprised dental casts from 74 children aged 8.9 ± 1 years. Standardized digital photographs were acquired at 1:1 magnification. A coordinate system was developed using digital image-processing software (Photoshop CS4 and Adobe Illustrator). Incisor and molar overjet, Angle's classification, and arch contraction were recorded. Descriptive statistics, paired t-tests, and kappa statistics were used to compare the cleft and noncleft sides. Results: A negative overjet of −1 to −5 mm was often present at the incisors, with greater frequency and magnitude on the cleft side. Class II molar relation was more frequent on the cleft side (61.1%) than on the noncleft side (47.2%). Significantly greater contraction of the cleft side deciduous canine and deciduous first molar was noted, while the difference was very minor at the first permanent molar. Conclusions: Cleft side maxillary arch contraction was most severe in the deciduous canine and first deciduous molar region and progressively less severe in the posterior region of the arch. A greater frequency and severity of negative overjet and Class II molar relationship was seen on the cleft side.

scholarly journals Assessment of role of consanguinity in formation of cleft lip and cleft palate

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1027-1031
Author(s):  
Joshini Shanmugam ◽  
Senthil Murugan P ◽  
Suresh V
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Consanguineous Marriages ◽  
Cleft Lip Palate ◽  
Chi Square Test ◽  
History Of ◽  
Autosomal Recessive Diseases

Consanguinity is considered a significant factor in autosomal recessive diseases; it has also been associated with congenital anomalies such as hydrocephalus, polydactilia and Cleft Lip and Palate deformities. The risk of congenital conditions is higher in subjects born of first degree consanguineous parents compared with those of non-consanguineous marriages. The aim of this study is to evaluate the prevalence of consanguinity with formation of cleft lip/ cleft palate formation in Tamil, Telugu population. This is a retrospective study. The details of 86,000 patient records were reviewed and analysed, out of which 76 patients who had undergone surgical treatment for cleft lip and cleft palate deformities between June 2019 to march 2020 were included in this study. The details like age, gender, family history and cleft diagnosis were evaluated and entered in SPSS and analysed through a chi-square test. It was observed that 11% of patients reported with history of consanguineous marriages which was associated with formation of cleft lip/palate. Within the limits of the study, it was concluded that consanguinity had a significant role in formation of cleft lip/cleft palate.

scholarly journals Pattern of Distribution of Malocclusions in Patients Seeking Orthodontic Treatment at BPKIHS from Sunsari District of Nepal

1970 ◽  
Vol 8 (2) ◽  
pp. 93-96 ◽  
Author(s):  
JN Sharma
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Open Bite ◽  
Class I ◽  
Kappa Statistics ◽  
Class Iii ◽  
Anterior Open Bite ◽  
Dental Surgery ◽  
Standard Format

Setting: College of Dental Surgery, B P Koirala Institute of Health Sciences, Sunsari, Nepal. Aims: To evaluate the pattern and distribution of malocclusions in patients seeking for orthodontic treatment from Sunsari district of Nepal. Material and Methods: Total of 350 patients who were permanent inhabitants of Sunsari district of age range 8-36 years were included in the study. A standard format was prepared to record the data. Descriptive statistics for mean, standard deviation and frequencies were calculated. Ages and Class I, II and III malocclusions were cross tabulated to check for any relationship using ANOVA. Intra investigator error was calculated using kappa statistics. Results: The prevalence of Class I, II and III malocclusions were 62.28 %, 29.4%.and 8.2% respectively. Out of 350 cases studied for various occlusal traits the nature of distribution of various occlusal findings were: absent teeth-12.6%, supernumerary teeth-2.9% ectopic eruption-7.1%, midline diastema-16%, incisor crowding-52.9%, spacing-30%, malformations-3.1%, increased overjet (>4mm)- 42.3%, anterior open bite . 5.1% and deep bite (>4mm )- 40 % and cleft lip and palate was 0.28%. Most prevalent age group seeking orthodontic treatment was 12-24 years with females to male ratio of 2.3:1 Comparison of mean ages with different malocclusion groups using ANOVA was statistically not significant. Conclusion: Class I malocclusion was the most prevalent followed by Class II malocclusion and the Class III malocclusion showed least prevalence. There were diverse occlusal traits. Keywords: Malocclusion; Angle’s Classification; Sunsari; BPKIHS

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