Does the GOSLON yardstick predict the need for orthognathic surgery?

Kirstin Miteff,Steve Singer,Wendy Nicholls,Mark Jonathon Walters,David Gillett,Shahriar Raj Zaman

doi:10.34239/ajops.v1n1.61

Abstract

The ability of the GOSLON Yardstick, scored at 9 years of age, to predict the need for orthognathic surgery in a cohort of complete Unilateral Cleft Lip and Palate (UCLP) patients treated in the Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Western Australia was assessed. Sixty six consecutively treated UCLP patients with dental models at 9 years of age and details on referral for orthognathic surgery were retrieved from medical and dental records. Cephalometric appraisal at 18 year old patients was also conducted. Twenty four of sixty six patients were referred for orthognathic surgery at growth completion (36%). Referral pattern stratified by GOSLON scores at 9 years of age found that four of four patients (100%), with a GOSLON score of 5 were referred for orthognathic surgery. Eleven of fourteen patients (79%) with a GOSLON 4, four of sixteen patients (25%) with a GOSLON 3 and five of thirty two patients (15%) with a GOSLON 2 were referred. No patient recorded a GOSLON 1 at age 9. Cephalometric appraisals conducted on thirty eight subjects at age 18 significantly discriminated the referral group from the non-referral group. Of the seventeen patients referred for surgery eight fulfilled the objective cephalometric criteria for orthognathic surgery, none of the patients who were not referred for orthognathic surgery fulfilled the objective criteria. The GOSLON Yardstick was found to be a good predictor of the need for orthognathic surgery at growth completion in our unit.

Highlights

The GOSLON yardstick was developed in 19871 as a clinical tool to rate the dental arch relationships of patients with repaired complete unilateral cleft lip and palate (UCLP) in the mixed dentition
The ability of the GOSLON yardstick, scored at nine years of age, to predict the need for orthognathic surgery in a cohort of complete unilateral cleft lip and palate (UCLP) patients treated in the Cleft Lip and Palate (CLP) unit, Princess Margaret Hospital (PMH) for Children, Perth, Western Australia, was assessed
The GOSLON yardstick uses a set of reference models to rate the degree of horizontal, transverse and Miteff, Walters, Zaman, Nicholls, Singer, Gillett: Does the GOSLON yardstick predict the need for orthognathic surgery?

Summary

Introduction

The GOSLON yardstick was developed in 19871 as a clinical tool to rate the dental arch relationships of patients with repaired complete unilateral cleft lip and palate (UCLP) in the mixed dentition. An assumption was made that the GOSLON score would predict the degree of difficulty to correct a malocclusion in a patient with a UCLP.[1,2] The GOSLON yardstick uses a set of reference models to rate the degree of horizontal, transverse and Miteff, Walters, Zaman, Nicholls, Singer, Gillett: Does the GOSLON yardstick predict the need for orthognathic surgery?. The degree of horizontal discrepancy is measured by the overjet and is regarded as the most important feature in the assessment.[3] The score is considered to be a reflection of the degree of maxillary growth disturbance resulting from the primary cleft repair[4] thereby influencing a patient’s dental arch relationship.[5]. Because of its high intra- and inter-rater reliability[1,6,7] and ease of use the GOSLON yardstick has become an accepted method for measuring cleft dental arch relationships in internal audits,[8,9] as a method of comparing the treatment outcome between different cleft centres[10,11,12,13,14,15] and as a proposed tool to measure the alteration of the dental arch relationship following changes in cleft treatment protocols.[6]

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Discussion

Conclusion