Agneta Karsten1, Agneta Marcusson2, Kirsti Hurmerinta3, Arja Heliövaara3, Annelise Küseler4, Pål Skaare5, Haydn Bellardie6, Elisabeth Rønning5, William Shaw7, Kirsten Mølsted8, Paul Sæle9, Eli Brinck9, Sara Rizell10, Midia Najal Chalier10, Philip Eyres7, Gunvor Semb5,7. 1. a Stockholm Craniofacial Team, Division of Orthodontics, Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden. 2. b Department of Dentofacial Orthopedics, Maxillofacial Unit , University Hospital , Linköping , Sweden. 3. c Cleft Palate and Craniofacial Center, Helsinki University Central Hospital , Helsinki , Finland. 4. d Cleft Palate Center , Aarhus , Denmark. 5. e Department of Plastic and Reconstructive Surgery , Oslo University Hospital Rikshospitalet , Oslo , Norway. 6. f Greater Manchester Cleft Lip and Palate Unit, Royal Manchester Childrens' Hospital , Manchester , UK. 7. g Dental School, University of Manchester , Manchester , UK. 8. h Copenhagen Cleft Palate Center, University Hospital of Copenhagen , Copenhagen , Denmark. 9. i Oral Health Center of Expertise/Western Norway , Bergen , Norway. 10. j Department of Odontology , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
Abstract
BACKGROUND AND AIM: Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7-6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion. RESULTS: The inter- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6) varied from -3.24 (Trial 3A) to -3.82 (Trial 3D) and the mean non-cleft-side scores (0 to -6) varied from -0.60 (Trial 2C) to -1.30 (Trial 3A); however, no significant differences were found within the trials. CONCLUSION: There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial. TRIAL REGISTRATION: ISRCTN29932826.
BACKGROUND AND AIM: Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7-6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion. RESULTS: The inter- and intra-examiner reliability was good-to-excellent (0.61-0.94; 0.66-1.0, respectively). The mean total scores (+2 to -18) varied from -5.56 (Trial 2C) to -7.21 (Trial 3D). The mean anterior scores (+2 to -6) varied from -1.66 (Trial 2C) to -2.56 (Trial 3A). The mean posterior cleft-side scores (0 to -6) varied from -3.24 (Trial 3A) to -3.82 (Trial 3D) and the mean non-cleft-side scores (0 to -6) varied from -0.60 (Trial 2C) to -1.30 (Trial 3A); however, no significant differences were found within the trials. CONCLUSION: There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial. TRIAL REGISTRATION: ISRCTN29932826.
Entities:
Keywords:
Scandcleft; Unilateral cleft lip and palate; dental occlusion at 5 years; randomised controlled trials; the original Huddart and Bodenham index
Authors: Christine B Staudt; Julia Bollhalder; Martina Eichenberger; Giorgio La Scala; Georges Herzog; Daniel B Wiedemeier; Gregory S Antonarakis Journal: Cleft Palate Craniofac J Date: 2021-07-08