Top

Published in:

01-04-2019 | Original Article

A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients

Authors: Laurent AM Thierens, Arianne Lewyllie, Liesbeth Temmerman, Noëmi MC De Roo, An Verdonck, Maria Cadenas de Llano Perula, Guy Willems, Guy AM De Pauw

Published in: Clinical Oral Investigations | Issue 4/2019

Abstract

Objectives

The objectives of this retrospective equivalence trial were to assess the dental arch relationship of 5- to 6-year-old patients with unilateral cleft lip and palate (UCLP) treated in two specialized cleft centers with a different surgical protocol using the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system, and to determine the correlation between these two scoring indices.

Materials and methods

The dental arch relationship of seventy-three 5- to 6-year-old patients with complete UCLP was evaluated on plaster casts using the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system. The sagittal occlusion, overbite, and overjet were also recorded. Inter- and intra-examiner agreement was determined using Intraclass Correlation Coefficients.

Results

A good to very good inter- and intra-examiner agreement was found. No significant mean difference in outcome based on the 5-Year-Olds’ Index, the modified Huddart/Bodenham scoring system, overjet, or overbite was detected. For mean difference in sagittal occlusion, the hypothesis that both centers are clinically equivalent was confirmed. A strong negative correlation (r_s = − 0.832) between the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system was found.

Conclusions

The dental arch relationship of 5- to 6-year-old unilateral cleft patients treated in two Belgian cleft centers is clinically equivalent based on sagittal occlusion, despite substantial differences in their treatment protocol. Clinical equivalence for other parameters was not confirmed. There is a strong correlation between the 5-Year-Olds’ Index and the modified Huddart/Bodenham scoring system.

Clinical relevance

A well-implemented treatment protocol for cleft patients is of the utmost importance, but case load and skill of the surgeon are also important factors for the quality of the results.

Mars M, Asher-McDade C, Brattstrom V, Dahl E, McWilliam J, Molsted K, Plint DA, Prahl-Andersen B, Semb G, Shaw WC et al (1992) A six-center international study of treatment outcome in patients with clefts of the lip and palate: part 3. Dental arch relationships. Cleft Palate Craniofac J 29:405–408. https://doi.org/10.1597/1545-1569(1992)029<0405:ASCISO>2.3.CO;2 CrossRefPubMed

Altalibi M, Saltaji H, Edwards R, Major PW, Flores-Mir C (2013) Indices to assess malocclusions in patients with cleft lip and palate. Eur J Orthod 35:772–782. https://doi.org/10.1093/ejo/cjt009 CrossRefPubMed

Mars M, Plint DA, Houston WJ, Bergland O, Semb G (1987) The Goslon yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate. Cleft Palate J 24:314–322PubMed

Atack N, Hathorn I, Mars M, Sandy J (1997) Study models of 5 year old children as predictors of surgical outcome in unilateral cleft lip and palate. Eur J Orthod 19:165–170CrossRefPubMed

Huddart AG, Bodenham RS (1972) The evaluation of arch form and occlusion in unilateral cleft palate subjects. Cleft Palate J 9:194–209PubMed

Mossey PA, Clark JD, Gray D (2003) Preliminary investigation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Eur J Orthod 25:251–257CrossRefPubMed

Dobbyn L, Gillgrass T, McIntyre G, Macfarlane T, Mossey P (2015) Validating the clinical use of the modified Huddart and Bodenham scoring system for outcome in cleft lip and/or palate. Cleft Palate Craniofac J 52:671–675. https://doi.org/10.1597/12-170 CrossRefPubMed

Jones T, Leary S, Atack N, Ireland T, Sandy J (2016) Which index should be used to measure primary surgical outcome for unilateral cleft lip and palate patients? Eur J Orthod 38:345–352. https://doi.org/10.1093/ejo/cjw013 CrossRefPubMedPubMedCentral

Gray D, Mossey PA (2005) Evaluation of a modified Huddart/Bodenham scoring system for assessment of maxillary arch constriction in unilateral cleft lip and palate subjects. Eur J Orthod 27:507–511. https://doi.org/10.1093/ejo/cji019 CrossRefPubMed

10.

Dobbyn LM, Weir JT, Macfarlane TV, Mossey PA (2012) Calibration of the modified Huddart and Bodenham scoring system against the GOSLON/5-year-olds’ index for unilateral cleft lip and palate. Eur J Orthod 34:762–767. https://doi.org/10.1093/ejo/cjr092 CrossRefPubMed

11.

Almuhizi Y, Leser A, Pegelow M (2016) Correlation between the modified Huddart and Bodenham index and the GOSLON yardstick for assessing occlusal characteristics at 5 and 10 years of age in individuals born with unilateral cleft lip and palate. Eur J Orthod 38:359–365. https://doi.org/10.1093/ejo/cjw046 CrossRefPubMed

12.

Al-Ghatam R, Jones TE, Ireland AJ, Atack NE, Chawla O, Deacon S, Albery L, Cobb AR, Cadogan J, Leary S, Waylen A, Wills AK, Richard B, Bella H, Ness AR, Sandy JR (2015) Structural outcomes in the cleft care UK study. Part 2: dento-facial outcomes. Orthod Craniofac Res 18(Suppl 2):14–24. https://doi.org/10.1111/ocr.12109 CrossRefPubMedPubMedCentral

13.

Ness AR, Wills AK, Waylen A, Al-Ghatam R, Jones TE, Preston R, Ireland AJ, Persson M, Smallridge J, Hall AJ, Sell D, Sandy JR (2015) Centralization of cleft care in the UK. Part 6: a tale of two studies. Orthod Craniofac Res 18(Suppl 2):56–62. https://doi.org/10.1111/ocr.12111 CrossRefPubMedPubMedCentral

14.

Persson M, Sandy JR, Waylen A, Wills AK, Al-Ghatam R, Ireland AJ, Hall AJ, Hollingworth W, Jones T, Peters TJ, Preston R, Sell D, Smallridge J, Worthington H, Ness AR (2015) A cross-sectional survey of 5-year-old children with non-syndromic unilateral cleft lip and palate: the cleft care UK study. Part 1: background and methodology. Orthod Craniofac Res 18(Suppl 2):1–13. https://doi.org/10.1111/ocr.12104 CrossRefPubMedPubMedCentral

15.

Sell D, Mildinhall S, Albery L, Wills AK, Sandy JR, Ness AR (2015) The cleft care UK study. Part 4: perceptual speech outcomes. Orthod Craniofac Res 18(Suppl 2):36–46. https://doi.org/10.1111/ocr.12112 CrossRefPubMedPubMedCentral

16.

Smallridge J, Hall AJ, Chorbachi R, Parfect V, Persson M, Ireland AJ, Wills AK, Ness AR, Sandy JR (2015) Functional outcomes in the cleft care UK study—part 3: oral health and audiology. Orthod Craniofac Res 18(Suppl 2):25–35. https://doi.org/10.1111/ocr.12110 CrossRefPubMedPubMedCentral

17.

Waylen A, Ness AR, Wills AK, Persson M, Rumsey N, Sandy JR (2015) Cleft care UK study. Part 5: child psychosocial outcomes and satisfaction with cleft services. Orthod Craniofac Res 18(Suppl 2):47–55. https://doi.org/10.1111/ocr.12113 CrossRefPubMedPubMedCentral

18.

Millard DR (1968) Extensions of rotation-advancement principle for wide unilateral cleft lips. Plast Reconstr Surg 42:535–539. https://doi.org/10.1097/00006534-196812000-00004 CrossRefPubMed

19.

Sommerlad BC (2003) A technique for cleft palate repair. Plast Reconstr Surg 112:1542–1548. https://doi.org/10.1097/01.Prs.0000085599.84458.D2 CrossRefPubMed

20.

Brauer RO, Cronin TD (1983) The Tennison lip repair revisited. Plast Reconstr Surg 71:633–640. https://doi.org/10.1097/00006534-198305000-00009 CrossRefPubMed

21.

Vander Poorten V, Ostyn F, Van Kerckhoven W, Wellens W, Breuls M, Verdonck A, Vergalle C, Schoenaers JH (2006) The Leuven staged supraperiosteal retropositioning repair: long-term velopharyngeal function in non-syndromic cleft palate. B-ENT 2(Suppl 4):35–43PubMed

22.

Atack N, Hathorn IS, Semb G, Dowell T, Sandy JR (1997) A new index for assessing surgical outcome in unilateral cleft lip and palate subjects aged five: reproducibility and validity. Cleft Palate Craniofac J 34:242–246. https://doi.org/10.1597/1545-1569(1997)034<0242:ANIFAS>2.3.CO;2 CrossRefPubMed

23.

Heidbuchel KL, Kuijpers-Jagtman AM (1997) Maxillary and mandibular dental-arch dimensions and occlusion in bilateral cleft lip and palate patients form 3 to 17 years of age. Cleft Palate Craniofac J 34:21–26. https://doi.org/10.1597/1545-1569(1997)034<0021:MAMDAD>2.3.CO;2 CrossRefPubMed

24.

Bongaarts CA, Kuijpers-Jagtman AM, van 't Hof MA, Prahl-Andersen B (2004) The effect of infant orthopedics on the occlusion of the deciduous dentition in children with complete unilateral cleft lip and palate (Dutchcleft). Cleft Palate Craniofac J 41:633–641. https://doi.org/10.1597/03-051.1 CrossRefPubMed

25.

Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London

26.

Wiens BL (2002) Choosing an equivalence limit for noninferiority or equivalence studies. Control Clin Trials 23:2–14CrossRefPubMed

27.

Summers CJ (1971) The occlusal index: a system for identifying and scoring occlusal disorders. Am J Orthod Dentofac Orthop 59:552–567CrossRef

28.

Flinn W, Long RE, Garattini G, Semb G (2006) A multicenter outcomes assessment of five-year-old patients with unilateral cleft lip and palate. Cleft Palate Craniofac J 43:253–258. https://doi.org/10.1597/04-093.1 CrossRefPubMed

29.

Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC (2009) Cleft lip and palate. Lancet 374:1773–1785. https://doi.org/10.1016/S0140-6736(09)60695-4 CrossRef

30.

Rittler M, Lopez-Camelo J, Castilla EE (2004) Sex ratio and associated risk factors for 50 congenital anomaly types: clues for causal heterogeneity. Birth Defects Res A Clin Mol Teratol 70:13–19. https://doi.org/10.1002/bdra.10131 CrossRefPubMed

31.

Atack N, Hathorn I, Dowell T, Sandy J, Semb G, Leach A (1998) Early detection of differences in surgical outcome for cleft lip and palate. Br J Orthod 25:181–185. https://doi.org/10.1093/ortho/25.3.181 CrossRefPubMed

32.

Johnson N, Williams AC, Singer S, Southall P, Atack N, Sandy JR (2000) Dentoalveolar relations in children born with a unilateral cleft lip and palate (UCLP) in Western Australia. Cleft Palate Craniofac J 37:12–16. https://doi.org/10.1597/1545-1569(2000)037<0012:DRICBW>2.3.CO;2 CrossRefPubMed

33.

Williams AC, Bearn D, Mildinhall S, Murphy T, Sell D, Shaw WC, Murray JJ, Sandy JR (2001) Cleft lip and palate care in the United Kingdom—the clinical standards advisory group (CSAG) study. Part 2: dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J 38:24–29. https://doi.org/10.1597/1545-1569(2001)038<0024:CLAPCI>2.0.CO;2 CrossRefPubMed

34.

DiBiase AT, DiBiase DD, Hay NJ, Sommerlad BC (2002) The relationship between arch dimensions and the 5-year index in the primary dentition of patients with complete UCLP. Cleft Palate Craniofac J 39:635–640. https://doi.org/10.1597/1545-1569(2002)039<0635:TRBADA>2.0.CO;2 CrossRefPubMed

35.

Suzuki A, Yoshizaki K, Honda Y, Sasaguri M, Kubota Y, Nakamura N, Ohishi M, Oka M, Tashiro H, Katsuki T, Fujino H (2007) Retrospective evaluation of treatment outcome in Japanese children with complete unilateral cleft lip and palate. Part 1: five-year-olds’ index for dental arch relationships. Cleft Palate Craniofac J 44:434–443. https://doi.org/10.1597/06-069.1 CrossRefPubMed

36.

Clark SA, Atack NE, Ewings P, Hathorn IS, Mercer NS (2007) Early surgical outcomes in 5-year-old patients with repaired unilateral cleft lip and palate. Cleft Palate Craniofac J 44:235–238. https://doi.org/10.1597/06-044 CrossRefPubMed

37.

Mikoya T, Shibukawa T, Susami T, Sato Y, Tengan T, Katashima H, Oyama A, Matsuzawa Y, Ito Y, Funayama E (2015) Dental arch relationship outcomes in one- and two-stage palatoplasty for Japanese patients with complete unilateral cleft lip and palate. Cleft Palate Craniofac J 52:277–286. https://doi.org/10.1597/13-285 CrossRefPubMed

38.

Haque S, Alam MK, Khamis MF (2016) Treatment outcome of Bangladeshi UCLP patients based on both phenotype and postnatal treatment factors using modified Huddart Bodenham (mHB) index. Cleft Palate Craniofac J 1:15293–15973. https://doi.org/10.1597/15-293 CrossRef

39.

Chawla O, Atack NE, Deacon S, Leary SD, Ireland AJ, Sandy JR (2013) Three-dimensional digital models for rating dental arch relationships in unilateral cleft lip and palate. Cleft Palate Craniofac J 50:182–186. https://doi.org/10.1597/11-283 CrossRefPubMed

40.

Asquith J, McIntyre G (2012) Dental arch relationships on three-dimensional digital study models and conventional plaster study models for patients with unilateral cleft lip and palate. Cleft Palate Craniofac J 49:530–534. https://doi.org/10.1597/10-099 CrossRefPubMed

41.

Chawla O, Deacon SA, Atack NE, Ireland AJ, Sandy JR (2012) The 5-year-olds’ index: determining the optimal format for rating dental arch relationships in unilateral cleft lip and palate. Eur J Orthod 34:768–772. https://doi.org/10.1093/ejo/cjr096 CrossRefPubMed

42.

Martin CB, Ma X, McIntyre GT, Wang W, Lin P, Chalmers EV, Mossey PA (2016) The validity and reliability of an automated method of scoring dental arch relationships in unilateral cleft lip and palate using the modified Huddart-Bodenham scoring system. Eur J Orthod 38:353–358. https://doi.org/10.1093/ejo/cjw031 CrossRefPubMed

43.

Burhardt L, Livas C, Kerdijk W, van der Meer WJ, Ren Y (2016) Treatment comfort, time perception, and preference for conventional and digital impression techniques: a comparative study in young patients. Am J Orthod Dentofac Orthop 150:261–267. https://doi.org/10.1016/j.ajodo.2015.12.027 CrossRef

44.

Chalmers EV, McIntyre GT, Wang W, Gillgrass T, Martin CB, Mossey PA (2016) Intraoral 3D scanning or dental impressions for the assessment of dental arch relationships in cleft care: which is superior? Cleft Palate Craniofac J 53:568–577. https://doi.org/10.1597/15-036 CrossRefPubMed

45.

Kuijpers-Jagtman AMREL (2000) The influence of surgery and orthopedic treatment on maxillofacial growth and maxillary arch development in patients treated for orofacial clefts. Cleft Palate Craniofac J 37:527–527CrossRef

46.

Nollet PJ, Katsaros C, van’t Hof MA, Semb G, Shaw WC, Kuijpers-Jagtman AM (2005) Treatment outcome after two-stage palatal closure in unilateral cleft lip and palate: a comparison with Eurocleft. Cleft Palate Craniofac J 42:512–516. https://doi.org/10.1597/04-129.1 CrossRefPubMed

Title: A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients
Authors: Laurent AM Thierens
Arianne Lewyllie
Liesbeth Temmerman
Noëmi MC De Roo
An Verdonck
Maria Cadenas de Llano Perula
Guy Willems
Guy AM De Pauw
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 4/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2601-0

At a glance: The STEP trials

Springer Medicine

A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 4/2019

Glass carbomer and compomer for ART restorations: 3-year results of a randomized clinical trial

Evaluation of the efficacy of calcium silicate vs. glass ionomer cement indirect pulp capping and restoration assessment criteria: a randomised controlled clinical trial—2-year results

Resin composite thickness’ influence on L*a*b* coordinates and translucency

Reduced CD8+ T cells infiltration can be associated to a malignant transformation in potentially malignant oral epithelial lesions

MTA and biodentine for primary teeth pulpotomy: a systematic review and meta-analysis of clinical trials

Dentinal tubule penetration of AH Plus, BC Sealer and a novel tricalcium silicate sealer: a confocal laser scanning microscopy study

Resin composite thickness’ influence on Lab* coordinates and translucency