Assessment of complete unilateral cleft lip and palate patients: Determination of factors effecting dental arch relationships

Int J Pediatr Otorhinolaryngol. 2017 Jan:92:70-74. doi: 10.1016/j.ijporl.2016.11.006. Epub 2016 Nov 11.

Abstract

Objectives: The purpose of the current study was to assess the treatment outcome of non-syndromic patients having complete unilateral cleft lip and palate (CUCLP) by using GOSLON index and to determine any association of pre and/or postnatal factors with the treatment outcome.

Materials and methods: One hundred and one sets of dental models of patients having CUCLP were assessed in this retrospective study. Five examiners that were blinded to case-specific information scored the dental models at two instances with an interval of two weeks to ensure memory bias elimination (5 × 101 × 2 = 1010 observations). Calibration courses were conducted prior to scoring and each examiner was provided with scoring sheets, pictures of GOSLON reference models and flowcharts explaining the scoring method.

Results: According to GOSLON index, a mean (SD) GOSLON score of 3.04 (1.25) was determined. Based on treatment outcome groups, 62 patients had favorable (grade 1, 2, and 3) and 39 cases had unfavorable (grade 4 and 5) treatment outcome. Chi-square tests revealed a significant association of gender (P = 0.002), cheiloplasty (P = 0.001) and palatoplasty (P < 0.001) with the treatment outcome. These associations were further explored by entering five independent variables in the logistic regression models.

Conclusions: The current study found an intermediate treatment outcome of CUCLP cases using GOSLON index. Final logistic model showed that gender, cheiloplasty, and palatoplasty had significantly higher odds of influencing outcomes. Identification of these factors provides us an evidence of traditional and outdated surgical methods and encourages clinicians to adopt current techniques to improve treatment outcomes. This implementation will facilitate comparison between the traditional and current techniques of primary surgical repair.

Keywords: Cleft lip; Cleft palate; GOSLON; Growth; Logistic models; Outcomes.

Publication types

  • Observational Study

MeSH terms

  • Calibration
  • Child
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Dental Arch*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Malocclusion
  • Plastic Surgery Procedures*
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome