title: Dental arch relationship in children with complete unilateral cleft lip and palate following one-stage and three-stage surgical protocols.
abstract: The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft at 9.2 months (SD, 2.0), were compared with a sample of 97 patients (mean age, 8.7 years; SD, 0.9), consecutively treated with a three-stage protocol including delayed hard palate closure in another center. The dental casts were assigned random numbers to blind their origin. Four raters graded dental arch relationship and palatal morphology using the EUROCRAN index. The strength of agreement of rating was assessed with kappa statistics. Independent t tests were run to compare the EUROCRAN scores between one-stage and three-stage samples, and Fisher's exact tests were performed to evaluate differences of distribution of the EUROCRAN grades. The intra- and inter-rater agreement was moderate to very good. Dental arch relationship in the one-stage sample was less favorable than in three-stage group (mean scores, 2.58 and 1.97 for one-stage and three-stage samples, respectively; p < 0.000). Palatal morphology in the one-stage sample was more favorable than in the three-stage group (mean scores, 1.79 and 1.96 for one-stage and three-stage samples, respectively; p = 0.047). The dental arch relationship following one-stage repair was less favorable than the outcome of three-stage repair. The palatal morphology following one-stage repair, however, was more favorable than the outcome of three-stage repair.
authors.affiliation: Department of Pediatric Surgery, Institute of Mother and Child, Kasprzaka Str. 17a, 01-211 Warsaw, Poland. pfudalej@gmail.com
authors.forename: Piotr
authors.initials: P
authors.lastname: Fudalej
authors.forename: Christos
authors.initials: C
authors.lastname: Katsaros
authors.forename: Catharina
authors.initials: C
authors.lastname: Bongaarts
authors.forename: Zofia
authors.initials: Z
authors.lastname: Dudkiewicz
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Kuijpers-Jagtman
mesh_terms: D000367:Age Factors; D000543:Alveoloplasty / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D002508:Cephalometry / Q000379:methods; D002648:Child; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D003724:Dental Arch / Q000473:pathology*; D005260:Female; D006801:Humans; D008046:Lip / Q000601:surgery; D008297:Male; D008310:Malocclusion / Q000145:classification / Q000473:pathology; D019647:Oral Surgical Procedures / Q000379:methods*; D009968:Orthodontic Appliances, Removable; D010156:Palatal Muscles / Q000601:surgery; D010158:Palatal Obturators; D021362:Palate, Hard / Q000473:pathology; D010160:Palate, Soft / Q000601:surgery; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D016896:Treatment Outcome; D055172:Vomer / Q000637:transplantation
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