Abstract
To evaluate dental arch relationship (DAR) using GOSLON Yardstick and also to explore the association between multiple factors (age, gender, UCLP types, UCLP side, Family history of cleft, family history of Class III malocclusion, techniques of cheiloplasty, techniques of palatoplasty) and DAR in children unilateral cleft lip and palate (UCLP) in different populations. Two hundred fifty-five laser scanned 3D digital models (LS3DM) of UCLP children (5–12 years) from Malaysia, Bangladesh, and Pakistan were included. The intra- and inter-examiner agreements were evaluated by kappa statistics, to compare the GOSLON mean score between the populations and to explore the responsible factors that affect DAR, one way ANOVA, and crude logistic regression analysis was used, respectively. The mean GOSLON score was 2.97; 3.40 and 3.09 in Malaysia, Bangladesh, and Pakistan, respectively. Twenty seven, 40, and 30 subjects were in unfavourable (category rating 4 and 5) groups in Malaysia, Bangladesh, and Pakistan, respectively. A significant association was found between techniques of palatoplasty (p = 0.03; p = 0.04 and p = 0.04 in Malaysia, Bangladesh, and Pakistan, respectively) and unfavourable DAR. Different cheiloplasty techniques (p = 0.04) and gender (p = 0.03) also exhibited noteworthy associations with unfavourable DAR in the Bangladeshi population. Bardach techniques of palatoplasty were significantly associated with unfavourable DAR in all three populations. Moreover, male UCLP and modified Millard techniques of cheiloplasty were also associated with unfavourable DAR in the Bangladeshi population.
Highlights
The prevalence of unilateral cleft lip and palate (UCLP) varies between countries with higher rates have been reported in Asians and American Indians which is 1 per 500 births whereas African derivative populations have the lower rates (1 per 2,500 births) [1]
The subjects’ age ranged between 5 and 12 years and who had completed their cheiloplasty and palatoplasty and without bone grafting were included in this study whereas any kind of missing records, syndromic UCLP, bilateral cleft, isolated cleft lip, and cleft palate were not included for further assessment
The association of multiple factors with favourable and unfavourable dental arch relationship (DAR) between the populations were explored. This range of age was chosen as most UCLP patients first received orthodontic treatment at the age of 5–6 years old [18]
Summary
The prevalence of unilateral cleft lip and palate (UCLP) varies between countries with higher rates have been reported in Asians and American Indians which is 1 per 500 births whereas African derivative populations have the lower rates (1 per 2,500 births) [1]. In Malaysia, it is found 1 per 941 live births [2] and 1 per 523 live births are reported in Pakistan [3] whereas 3.9:1000 live births are reported in Bangladesh [4] which is relatively higher than other regions in Asia. Despite variations between these countries, the impact of cleft lip and palate on both aesthetic and functional malformations are observed since birth [1, 5]. Surgeries and genotype factors have influences on the growth of maxilla reported previously [8, 9]
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