Which Index Should Be Used to Measure Primary Surgical Outcome for Unilateral Cleft Lip and Palate Patients?

Overview

Journal Eur J Orthod

Publisher Oxford University Press

Specialty Dentistry

Date 2016 Mar 19

PMID 26988992

Citations 4

Authors

Timothy Jones

Sam Leary

Nikki Atack

Tony Ireland

Jonathan Sandy

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the optimal dentoalveolar measure to assess unilateral cleft lip and palate (UCLP) patient plaster models.

Design: The models of 34 patients with UCLP taken at 5, 10, and 15-20 years of age were scored by two examiners on two separate occasions using five indices: the 5 Year Olds' (5YO), GOSLON, Modified Huddart/Bodenham (MHB), EUROCRAN, and Overjet. Reliability, validity, and ease of use were recorded for each index/examiner.

Setting: All models were scored in either Bristol Dental Hospital or Derriford Hospital, Plymouth, United Kingdom by senior orthodontic clinicians.

Results: Highest overall reliability was seen with MHB (Kappa = 0.56-0.97). Predictive validity was similar for MHB, GOSLON, and 5YO with a 50-65 per cent prediction of final outcome from 5 and 10 years. EUROCRAN palatal index showed no clear predictive validity (Spearman's correlation = 0.20-0.21). Agreement to the gold standard 5YO score at the 5-year age group was high for MHB (Kappa = 0.83) and moderate for GOSLON (Kappa = 0.59). Agreement to the gold standard GOSLON score at 10 years was highest for 5YO (Kappa = 0.69), followed by Overjet (Kappa = 0.59) and MHB (Kappa = 0.46). Time to score 34 models per index (minutes): GOSLON (13.4) < Overjet (13.6) < 5YO (19.4) < EUROCRAN (24.8) < MHB (27.4).

Conclusion: As an outcome measure of UCLP models, only MHB and 5YO indices can be recommended for use at 5 years of age and GOSLON at 10 years of age.

Citing Articles

Scandcleft randomized trials of primary surgery for unilateral cleft lip and palate: comparison of dental arch relationships and dental indices at 5, 8, and 10 years.

Heliovaara A, Kuseler A, Skaare P, Bellardie H, Molsted K, Karsten A Eur J Orthod. 2021; 44(3):258-267.

PMID: 34476476 PMC: 9127717. DOI: 10.1093/ejo/cjab055.

A retrospective intercenter comparison of two surgical protocols through the dental arch relationship of 5- to 6-year-old unilateral cleft patients.

Thierens L, Lewyllie A, Temmerman L, De Roo N, Verdonck A, Perula M Clin Oral Investig. 2018; 23(4):1777-1784.

PMID: 30171346 DOI: 10.1007/s00784-018-2601-0.

Predictive validity of the GOSLON Yardstick index in patients with unilateral cleft lip and palate: A systematic review.

Buj-Acosta C, Paredes-Gallardo V, Montiel-Company J, Albaladejo A, Bellot-Arcis C PLoS One. 2017; 12(6):e0178497.

PMID: 28570588 PMC: 5453533. DOI: 10.1371/journal.pone.0178497.

Three-dimensional evaluation of surgical techniques in neonates with orofacial cleft.

Carrara C, Ambrosio E, Mello B, Jorge P, Soares S, Machado M Ann Maxillofac Surg. 2017; 6(2):246-250.

PMID: 28299266 PMC: 5343636. DOI: 10.4103/2231-0746.200350.

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