title: Effect of infant orthopedics on facial appearance of toddlers with complete unilateral cleft lip and palate (Dutchcleft).
abstract: OBJECTIVE
  To evaluate the effect of infant orthopedics (IO) on facial appearance of 54 patients with unilateral cleft lip and palate (UCLP), aged 4 and 6 years.
  
  
  METHODS
  Prospective two-arm randomized controlled clinical trial in three Cleft Palate Centers in the Netherlands (Dutchcleft-trial).
  
  
  METHODS
  Patients were divided randomly into two groups. Half of the patients (IO+) had a plate until surgical closure of the soft palate at the age of +/- 52 weeks; the other half (IO-) received no intervention.
  
  
  METHODS
  Facial appearance at 4 and 6 years of age assessed on full face photographs and photographs showing only nose and mouth. Ratings were performed on a VAS-scale by professionals and laymen.
  
  
  RESULTS
  At 4 years of age the full face pictures of IO+ children were scored to be more attractive than those of IO- children. However, this difference had disappeared at 6 years of age. At the age of 6, only professionals saw a significant difference on nasolabial photographs between IO+ and IO-. Regression analysis showed a minor effect of occlusion, lip revision, or type of nose reconstruction on the esthetic results.
  
  
  CONCLUSIONS
  IO had a positive effect on full facial appearance of UCLP children at the age of 4 years, but at the age of 6, only professionals saw a positive effect of IO on the nasolabial photographs. This is irrelevant for UCLP patients since they deal with laymen in their daily life.
authors.affiliation: Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Center, 309 Tandheelkunde, Nijmegen, the Netherlands.
authors.forename: Catharina A M
authors.initials: CA
authors.lastname: Bongaarts
authors.forename: Birte
authors.initials: B
authors.lastname: Prahl-Andersen
authors.forename: Ewald M
authors.initials: EM
authors.lastname: Bronkhorst
authors.forename: Paul H M
authors.initials: PH
authors.lastname: Spauwen
authors.forename: Jan W
authors.initials: JW
authors.lastname: Mulder
authors.forename: J Michiel
authors.initials: JM
authors.lastname: Vaandrager
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kuijpers-Jagtman
mesh_terms: D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000473:pathology*; D002972:Cleft Palate / Q000473:pathology*; D004955:Esthetics, Dental; D005145:Face / Q000033:anatomy & histology*; D006801:Humans; D009989:Orthotic Devices; D023861:Photography, Dental; D011446:Prospective Studies; D012044:Regression Analysis