Index may show outcome differences in unilateral cleft lip and palate patients at 5-years of age

Abstract

Objective To examine whether differences in dental arch relationships of 5-year-old children born with a unilateral cleft lip and palate could be detected. Materials and Methods 40 sets of study models from each of two surgical units (Bristol & Oslo) were assessed using the 5-year old index. Models from each unit were assessed twice on one day at least 1 week apart by two examiners. Positions of the models in the series were reallocated using randomly generated numbers to minimise the influence of memory. Inter and intra-examiner variability was assessed using weighted kappa statistic. Results Intra-examiner variability was good to very good while inter-examiner variability was moderate to good. Both initial and subsequent examinations of the models by the examiners showed that the Oslo sample had a greater number of patients categories 1 and 2 which are considered to indicate better long term growth outcomes. Other differences were also detected between the two modelled samples suggesting that it is possible to detect differences in surgical outcomes at 5-years of age. Conclusions Differences in dental arch relationships in patients with unilateral CLP are apparent at 5 years of age and the use of this index appears to show difference in outcomes by which it may be feasible to compare outcomes from different surgeons. Atack N E, Hathorn I, Dowell T, Sandy J, Semb G, Leach A. Early detection of differences in surgical outcome for cleft lip and palate. Br J Ortho. 1998; 25; 181–185.