Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index

Karsten, Agneta; Marcusson, Agneta; Hurmerinta, Kirsti; Heliövaara, Arja; Küseler, Annelise; Skaare, Pål; Bellardie, Haydn; Rønning, Elisabeth; Shaw, William C.; Mølsted, Kirsten; Sæle, Paul; Brinck, Eli; Rizell, Sara; Chalier, Midia Najal; Eyres, Philip; Semb, Gunvor

doi:10.1080/2000656x.2016.1265529

Cited by 24 publications

(21 citation statements)

References 14 publications

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“…It has to be acknowledged that there is a difference in the results of our crude analysis with respect to what reported by the Scandcleft group about the Huddarth–Bodenham (HB) assessment on 5 years model in Trial 1 (Karsten et al, 2017). The difference is likely to be due not only to the fact that a larger number of patients was included in the Scandcleft study, since they were coming from 2 surgical centers, but also to the fact that the outcome was assessed on models belonging to a different age-group and using a different scale.…”

Section: Discussioncontrasting

confidence: 59%

“…It has to be acknowledged that there is a difference in the results of our crude analysis with respect to what reported by the Scandcleft group about the Huddarth-Bodenham (HB) assessment on 5 years model in Trial 1 (Karsten et al, 2017). .…”

Section: Discussioncontrasting

confidence: 56%

“…It is designed as a series of 3 parallel trials involving 9 Scandinavian and British surgical centers comparing their local methods with a common protocol (Semb et al, 2017;Shaw and Semb, 2017). Recently published preliminary results show no difference in occlusal relationships at age 5 in any of the trials (Heliovaara et al, 2017;Karsten et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate

Botticelli

Küseler

Marcusson

et al. 2019

The Cleft Palate-Craniofacial Journal

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Aim: To investigate whether infant cleft dimensions, in a surgical protocol with early or delayed hard palate closure, influence occlusion before orthodontics. Design: Subgroup analysis within a randomized trial of primary surgery (Scandcleft). Setting: Tertiary health care. One surgical centre. Patients and Methods: A total of 122 unilateral cleft lip and palate infants received primary cheilo-rhinoplasty and soft palate closure at age 4 months and were randomized for hard palate closure at age 12 versus 36 months. A novel 3D analysis of cleft size and morphology was performed on digitized presurgical models. Occlusion was scored on 8-year models using the modified Huddarth–Bodenham (MHB) Index and the Goslon Yardstick. Main Outcome Measurements: Differences in MHB and Goslon scores among the 2 surgical groups adjusted for cleft size. Results: The crude analysis showed no difference between the 2 surgical groups in Goslon scores but a better MHB ( P = .006) for the group who received delayed hard palate closure. When adjusting for the ratio between cleft surface and palatal surface (3D Infant Cleft Severity Ratio) and for posterior cleft dimensions at tuberosity level, the delayed hard palate closure group received 3.65 points better for MHB (confidence interval: 1.81; 5.48; P < .001) and showed a trend for reduced risk of receiving a Goslon of 4 or 5 ( P = .052). For posterior clefts larger than 9 mm, the Goslon score was better in the delayed hard palate closure group ( P = .033). Conclusions: Seen from an orthodontic perspective, when the soft palate is closed first, and the cleft is large, the timing of hard palate closure should be planned in relation to posterior cleft size.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate

Botticelli

Küseler

Marcusson

et al. 2019

The Cleft Palate-Craniofacial Journal

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“…However, the 5-Y index scoring cannot verify the details of discrepancies because it is a general overview measure. On the other hand, the HB index would be effective to make up for the 5-Y index when a more detailed description of treatment outcome, such as absolute measurement of dental arch constriction, would be required (Bartzela et al, 2011), although it has disadvantages in that it does not assess the skeletal component of the malocclusion and cannot differentiate between a generalized mild malocclusion and a localized severe malocclusion nor assess the vertical discrepancies of the malocclusion (Karsten et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Dental Arch Relationship Outcomes Following 2-Stage Palatoplasty for Japanese Patients With Complete Unilateral Cleft Lip and Palate: A 3-Center Study

Junya

Mikoya

Ito

et al. 2021

The Cleft Palate Craniofacial Journal

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Objective: To compare dental arch relationship outcomes following 3 different 2-stage palatal repair protocols. Design: Retrospective, cross sectional. Setting: Three cleft palate centers (A, B, C) in Japan. Patients: Ninety (A: 39, B: 26, C: 25) consecutively treated Japanese patients with complete unilateral cleft lip and palate. Interventions: In A, the soft palate and the posterior half of the hard palate were repaired at a mean age of 1 year 7 months. In B, the soft palate and hard palate were closed separately at a mean age of 1 year 6 months and 5 years 8 months, respectively. In C, the soft palate and hard palate were closed at a mean age of 1 year and 1 year 5 months, respectively. Main Outcome Measures: Dental arch relationships were assessed using the 5-Year-Olds’ (5-Y) index by 5 raters and the Huddart/Bodenham (HB) index by 2 raters. Results: Intra- and inter-rater reliabilities showed substantial or almost perfect agreement for the 5-Y and HB ratings. No significant differences in mean values and distributions of 5-Y scores were found among the 3 centers. The mean HB index scores of molars on the minor segment were significantly smaller in C than those in A and B ( P < .05). Conclusions: There were no significant differences in dental arch relationships at 5 years among the times and techniques of hard palate closure. However, further analysis of the possible influence of infant cleft size as a covariable on a larger sample size is needed.

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“…The more negative the score, the more severe the crossbite. These indices have proven reliable and capable of discriminating the quality of dental arch relationships in large inter‐centre studies 11‐15 but there is lack of long‐term follow‐up studies for categorizing and predicting treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

Prediction of orthognathic surgery need in children with unilateral cleft lip palate: Dental arch relationships and 5‐year‐olds' index

Heliövaara

Leikola

2021

Orthod Craniofacial Res

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Objective To evaluate whether dental arch relationships at 6 years of age can categorize treatment outcome and predict later need for orthognathic surgery in children with unilateral cleft lip and palate (UCLP). Setting and sample population A retrospective longitudinal single‐centre study. The study sample comprised 70 consecutive non‐syndromic children (47 boys) with complete UCLP operated on by pushback techniques during 1981‐1989 and followed until early adulthood in the same cleft centre. Materials and methods Dental casts and maxillomandibular relationships were assessed before orthodontic treatment and secondary alveolar bone grafting at mean age 6.1 years (range 5.6‐6.8) using the 5‐year‐olds' index and lateral cephalograms. The need for orthognathic surgery was retrieved from patient files. Student's t test, Pearson's correlation, and Kappa statistics were used in statistical analyses. Results Orthognathic surgery frequency was 41% (29/70). Those needing orthognathic surgery comprised all 3 patients with an index score of 5 (very poor), 14 of 17 (82%) scoring 4 (poor), 10 of 26 (38%) scoring 3 (fair), and 2 of 19 (11%) scoring 2 (good). Of the five patients with index score 1 (excellent), none needed osteotomies. The mean index score was 2.9. The score was significantly better in those without orthognathic surgery (2.4 versus 3.6). A significant negative correlation existed between the 5‐year‐olds' index and cephalometric angles ANB and anb. Conclusion The use of 5‐year‐olds' index may help to predict treatment outcome and the clinical need for orthognathic surgery especially in patients with the lowest and highest index scores.

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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index

Abstract: ISRCTN29932826.

Cited by 24 publications

References 14 publications

Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate

Do Infant Cleft Dimensions Have an Influence on Occlusal Relations? A Subgroup Analysis Within an RCT of Primary Surgery in Patients With Unilateral Cleft Lip and Palate

Dental Arch Relationship Outcomes Following 2-Stage Palatoplasty for Japanese Patients With Complete Unilateral Cleft Lip and Palate: A 3-Center Study

Prediction of orthognathic surgery need in children with unilateral cleft lip palate: Dental arch relationships and 5‐year‐olds' index

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