Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 4: Outcome Comparisons, Training, and Conclusions

2001 ◽  
Vol 38 (1) ◽  
pp. 38-43 ◽  
Author(s):  
David Bearn ◽  
Sue Mildinhall ◽  
Terrie Murphy ◽  
John J. Murray ◽  
Debbie Sell ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Health ◽  
Parent Satisfaction ◽  
Advisory Group ◽  
Dental Arch ◽  
The United Kingdom ◽  
Alveolar Bone Grafting

Objective A critical appraisal of cleft care in the United Kingdom. Design Retrospective comparative study. Setting All National Health Service cleft centers in the United Kingdom. Patients/Participants Children born with unilateral complete clefts of the lip and palate between April 1, 1982, and March 31, 1984 (12-year-olds), and April 1, 1989, and March 31, 1991 (5-year-olds). Newly appointed and senior cleft clinicians. Main Outcome Measures Skeletal pattern, dental arch relationship, success of alveolar bone grafting, dental health, facial appearance, oral health status, patient/parent satisfaction. Conclusions This paper highlights the poor outcomes for the fragmented cleft care in the United Kingdom, compared with European centers. There is an urgent need for a review of structure, organization, and training.

Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 2: Dentofacial Outcomes and Patient Satisfaction

2001 ◽  
Vol 38 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Alison C. Williams ◽  
David Bearn ◽  
Sue Mildinhall ◽  
Terrie Murphy ◽  
Debbie Sell ◽  
...  
Keyword(s):  
United Kingdom ◽  
Oral Health ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Parent Satisfaction ◽  
Bone Grafts ◽  
Dental Arch ◽  
Facial Appearance ◽  
The United Kingdom

Objective To describe facial development and appearance, quality of bone grafts, oral health, and patient/parent satisfaction, with clinical outcome, for children in two age cohorts born with unilateral cleft lip and palate (UCLP) throughout the United Kingdom. Design Cross-sectional outcome study. Setting Fifty National Health Service cleft centers. Participants Children born with complete UCLP between April 1, 1982, and March 31, 1984, (12-year-olds) and April 1, 1989, and March 31, 1991 (5-year-olds). Data were collected for 239 5-year-olds and 218 12-year-olds. The parents of these children were also interviewed to determine levels of satisfaction with care received. Main Outcome Measures Skeletal pattern, dental arch relationship, success of alveolar bone grafting, facial appearance, oral health status, and patient/parent satisfaction. Results Nearly 40% of 5- and 12-year-olds had poor dental arch relations, and 70% of 12-year-olds had midface retrusion. Fifteen percent of 12-year-olds had not received an alveolar bone graft, and only 58% of bone grafts that had been undertaken were successful. Twenty percent of 12-year-olds and 40% of 5-year-olds had untreated dental caries. Less than one-third of subjects had a good facial appearance as judged by a panel of experts. Levels of patient and parent satisfaction were generally high. Conclusion A rigorous evaluation of cleft care in the United Kingdom reveals disappointing outcomes.

Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 1: Background and Methodology

2001 ◽  
Vol 38 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Jonathan R. Sandy ◽  
Alison C. Williams ◽  
David Bearn ◽  
Sue Mildinhall ◽  
Terrie Murphy ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Parent Satisfaction ◽  
National Study ◽  
Advisory Group ◽  
Cross Sectional ◽  
Age Cohorts ◽  
The United Kingdom ◽  
Facial Development

Objective To review the history of cleft care in the United Kingdom and the rationale and methodology of a national study. Design Descriptive overview to introduce this series of papers. Setting Fifty National Health Service cleft teams. Patients/Participants Two age cohorts, 5-year-olds and 12-year-olds, with nonsyndromic complete unilateral cleft lip and palate and their parents. Main Outcome Measures Facial development and appearance, quality of bone grafts, speech, oral health and patient/parent satisfaction. Conclusions The case for a national assessment of cleft care is made. The methodology of the cross-sectional outcome study is described, together with a survey of training for recently appointed clinicians.

Early versus late alveolar bone grafting in unilateral cleft lip and palate: Dental arch relationships in pre-adolescent patients

2018 ◽  
Vol 46 (12) ◽  
pp. 2052-2057 ◽  
Author(s):  
Marina Siegenthaler ◽  
Lisa Bettelini ◽  
Andrzej Brudnicki ◽  
Martin Rachwalski ◽  
Piotr S. Fudalej
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Arch ◽  
Alveolar Bone Grafting ◽  
Adolescent Patients

Cleft Lip and Palate Care in the United Kingdom—The Clinical Standards Advisory Group (CSAG) Study. Part 3: Speech Outcomes

2001 ◽  
Vol 38 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Debbie Sell ◽  
Pamela Grunwell ◽  
Sue Mildinhall ◽  
Terrie Murphy ◽  
Tremaine A. O. Cornish ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Advisory Group ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Severe Degree ◽  
Therapy Intervention

Objective To summarize speech outcomes in children born with unilateral cleft lip and palate (UCLP) throughout the United Kingdom. Design Prospective descriptive study on a cross-sectional sample of children. Patients/Participants Data were collected for 238 5-year-olds (born between April 1, 1989, and March 31, 1991) and 218 12-year-olds (born between April 1, 1982, and March 31, 1984) with complete UCLP. Main Outcomes Ratings of intelligibility, nasality, “speech cleft type characteristics” and speech therapy intervention. Conclusions Nineteen percent of 5-year-olds and 4% of 12-year-olds were judged to be impossible to understand or just intelligible to strangers. Thirty-four percent of 5-year-olds and 17% of 12-year-olds had at least one serious error of consonant production. Eighteen percent of 5-year-olds and 12-year-olds had consistent hypernasality of mild, moderate, or severe degree. Approximately two-thirds of both age groups had undergone speech therapy.

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.

Dental arch relationship in 5-year-olds with complete unilateral cleft lip and palate after early alveolar bone grafting

2012 ◽  
Vol 15 (2) ◽  
pp. 117-123 ◽  
Author(s):  
B. Offert ◽  
P. Pazera ◽  
J. Janiszewska-Olszowska ◽  
K. Hozyasz ◽  
C. Katsaros ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Dental Arch ◽  
Alveolar Bone Grafting ◽  
Dental Arch Relationship
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